Employees eligible for medical and dental insurance enroll at the time of initial employment. Thereafter, employees can add or change insurance during the annual open enrollment period. Open enrollment generally occurs during May, and elections made at that time are effective July 1. Look for announcements for specific dates and times during the spring each year.
- 2024-2025 Health Insurance Open Enrollment
- Health Enhancement Program Compliance
- Adding/Dropping Dependents Outside of the Open Enrollment Period
- Special Payroll Insurance Rates
Affordable Care Act Notice
The Affordable Care Act requires us to inform all employees about the Health Insurance Marketplaces, which were set up to make it easier for consumers to compare plans and enroll in health insurance coverage. If you are eligible for employee health benefits through the State of Connecticut you will most likely not save money by purchasing coverage through the Marketplace. However, if you are not eligible for job-based health benefits, you may want to consider purchasing coverage through the Marketplace as explained here in the New Health Insurance Marketplace Coverage Options and Your Health Coverage notice.
Child Eligibility Rules
In accordance with the “Affordable Care Act” medical/prescription drug eligibility rules are revised to allow enrollment of the subscriber's natural, adopted child, or stepchild who are:
1. Up to age 26;
2. Any age if permanently and totally disabled, and who are enrolled as a dependent in the state plan or an equivalent plan at the time the disability occurred;
3. And, whether or not they are:
a. Married (a dependent's spouse or the employee's grandchildren are still not eligible for coverage);
b. Living in Connecticut;
c. Living with the employee;
d. In school;
e. Financially dependent on the employee; or
f. Eligible to enroll in their employer's health coverage.
Adding/Dropping Dependents Outside of the Open Enrollment Period
Once you choose your medical and dental plans, you cannot make changes during the plan year (July 1 to June 30) unless you experience a separate qualifying status change and contact Human Resources within 31 days of the event. Qualifying status changes include:
Legal Marital/Civil Union Status
Any event that changes your legal marital/civil union status, including marriage, civil union, divorce, death of a spouse, and legal separation.
The State and SEBAC have reached an agreement to clarify the allowable coverage in the event of legal separation, divorce and legal guardianship at age 18. When any of these events occur after July 1, 2012, an employee is required to notify the Benefits Unit within 31 days of the event.
Legal Separation
An employee who is granted a legal separation can either terminate spousal coverage or will be permitted to provide spousal coverage, subject to the following:
The employee must report the legal separation by submitting Comptroller's Form CO-1319 to the Benefits Unit 31 days of the judgment;
The employee must pay 100% of the cost of individual coverage for the spouse under the selected vendor and plan (includes both the employee and the state portion); and
The spouse's coverage will continue for three years or until either party remarries, whichever first occurs.
Divorce
In general, entry of a divorce decree requires that the former spouse be removed as a dependent under the plan within 31 days from the effective date. However, the laws of some states and certain divorce decrees require an employee to continue group medical plan coverage for a former spouse.
Employees required by state law or divorce decree to provide health benefit coverage for an ex-spouse will be allowed to continue coverage for a former spouse under the state plan, provided:
The employee must report the legal separation by submitting Comptroller's Form CO-1319 to the Benefits Unit 31 days of the judgment;
Coverage of the former spouse may continue for up to three years or until either party remarries, whichever comes earlier; and
The employee must pay 100% of the cost of individual coverage for the former spouse under the selected vendor and plan (includes both the employee and the state portion).
Where there is no court order or statute requiring continuation of coverage for a former spouse or member fails to provide timely notice of a marital status change, continuation coverage for the former spouse will be available under COBRA.
Legal Guardianship at Age 18
Under our medical/dental plan, an employee who has been named by the court as legal guardian of a minor child is permitted to cover that child as a dependent while the guardianship is in place. Most legal guardianship ends at age 18.
An employee who has been providing medical benefits to a child for whom he or she is the legal guardian must now identify that child as a ward (or temporary ward) - not as a "son" or "daughter" - and must provide employing agency with a copy of the legal guardianship order. Everyone who is providing coverage for a child who is currently (or was formerly) subject to legal guardianship must update the child's status by submitting a CO-1318 for each individual to Benefits Unit.
If an employee has been providing medical plan coverage to an individual after legal guardianship has ended (for example, a grandchild between the ages of 18 and 26) the employee must update the child's status by July 1, 2012 by submitting a CO-1318 and by providing further information to be used to determine the tax treatment of benefits provided. There are two possibilities.
For federal income tax purposes, for coverage after guardianship ends (children between 18 and 26), if the child continues to be the member's dependent, then the benefit should not be taxable to the employee. Form CO-1048 QR should be used by the employee to document the individual's status as a dependent for tax purposes. While employees are permitted to cover a former ward who is not a tax dependent, the fair market value of the benefit will be taxable. Form CO-1048 NQ should be filled out by the employee to designate individuals under the age of 26 who are covered under the plan but do not qualify as a dependent for federal tax purposes.
Number of Dependents
Any event that changes your number of dependents, including birth, death, adoption, and legal guardianship.
Employment Status
Any event that changes your, your spouse/civil union partner's, or another dependent's employment status, resulting in gaining or losing eligibility for coverage such as:
- Beginning or ending employment
- Stating or returning from an unpaid leave of absence
- Changing from part time to full time or vice versa
Dependent Status
Any event that causes your dependent to become eligible or ineligible for coverage under their current status as a dependent child, qualifying relative (child) or non-qualified child because of a change in age, student status, status as an IRS dependent, or similar circumstances.
Residence
A significant change in your plan of residence that affects your ability to access network providers (i.e., moving out of state).
All changes must be made within 31 days from the qualifying event. Employees must contact the HR Employee Resource Center at 860-679-2426 within 31 days for the appropriate paperwork and for additional instructions for submitting required supporting documentation (i.e., marriage license or full-length birth certificate). The change made must be consistent with the qualifying status change (i.e., getting married would allow an employee to add a spouse, but would not allow an employee to change plans).
Special Payroll Insurance Rates
Effective July 1, 2024
