An eligible employee may enroll in group coverage during these times:
If employee refuses initial opportunity they cannot join until:
Some small groups do not have open enrollments because of State laws forbidding them. Members of these groups may add eligible members at any time, provided they have met any company probationary period.
Before enrolling each employee, you must determine:
|Single||Employee with no dependents|
|Two-Person||Employee plus one eligible dependent (child, spouse, party to civil union or eligible domestic partner)|
|Family||Employee with more than one eligible dependent|
Note: Employees must enroll all eligible dependents with the following exception: a spouse, party to a civil union or eligible domestic partner who may refuse coverage.
Federal law requires that employers must provide all their employees with a copy of the Summary of Benefits and Coverage (SBC) with an application for insurance. Prior to completing an enrollment form, you must ensure that your employees have the SBC or SBCs that apply to the coverage for which they may enroll.
Enrolling employees: submit a completed group enrollment form.
Employees declining group coverage: submit a signed group enrollment form indicating refusal of coverage.
Note: Employees who refuse coverage cannot join the group until one of two things occurs: open enrollment or qualifiying event.
If a managed care plan is selected, a primary care physician must be selected for the subscriber and all eligible dependents in order for membership to become effective.