 |
FREQUENTLY ASKED BENEFIT QUESTIONS
MEDICAL / DENTAL
Q: Why can’t I change my Medical coverage at any time instead
of waiting for the Open Enrollment period?
A: Above any and all else, the main reason is ‘cause the IRS says
so. The Internal Revenue Code (IRC) governs the Institution’s Medical,
Dental and Flexibl Spending Account plans because these offer favorable
tax treatment to the participant. For the Medical and Dental plans,
this favorable treatment is in the form of paying your share of the
premium with pre-tax dollars. Even if you waive the opportunity for
this method of payment, because you have the opportunity to elect it
subjects you to the IRS rules.
It is important to note that the IRC allows exceptions for mid-year
changes. Within 30 days of certain qualifying events, you may make an
appropriate change. The most common examples of “qualifying events”
are the birth or adoption of a child, marriage or divorce, or change
in employment status. The change must be consistent with the event,
and cannot be retroactive.
Q: How do I look into buying individual Medical plans?
A: You can start with an Independent Insurance Agent (a broker)
who can help you select alternatives. If you are interested in BlueCross
BlueShield of Massachusetts, call 1-800-262-BLUE, and mention that you
are interested in an "individual plan."
Q: My daughter is over the age of 19 and was a full-time student last
Spring. She is taking the Fall semester off and will no longer be
a student. When does her health coverage end? Can she re-enroll when
she returns to being a full-time student? Does this affect my current
medical plan?
A: Her health coverage will automatically be cancelled as of November
1. Yes, your daughter can re-enroll in your medical coverage upon
returning to status as a full-time student. Keep in mind you will
need to submit a copy of the tuition bill to your Benefits Specialist
in order to add her back to your medical plan. If she is your
only child covered under your policy, your plan will be changed accordingly
until she re-enrolls.
CHILD CARE
Q: My spouse and I will be enrolling our toddler in
day care. Can I start participating in the Institution's Dependent
Care Assistance Program ("DCAP") in October?
A: WHOI has two plans that make up the DCAP.
The Dependent Care Flexible Spending Account requires
enrollment either during the Open Enrollment Period (typically in
November) or within 30 days after a "qualifying event." Examples
of a "qualifying event" are the birth or adoption of a child, or if
you or your spouse have a change in employment that allows you to
become eligible.
You can enroll in the Dependant Care Subsidy plan anytime
before November 1. Requests to begin participation in the Dependant
Care Subsidy for the current year will not be accepted after that
date.
LIFE INSURANCE
Q: I can get Term Life Insurance at lower premiums
than what the Institution offers. Why can’t WHOI offer lower
cost Life Insurance?
A. The Institution regularly “shops around”
for competitive rates on all of its insurance. In addition to price,
SERVICE is also very important. However, with Life Insurance there
is another factor that adds to the cost: guaranteed issue. “Guaranteed
issue” is an insurance industry phrase that means that anyone
who applies for it is guaranteed coverage. Any newly eligible employee,
or the employee’s spouse, can get life insurance through the
Institution’s group policy (subject to certain limits). This
additional risk to the insurer requires that it include additional
cost that is built into its premiums.
|
