Benefit FAQ's

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Welcome to Lewis & Clark's benefit frequently asked questions and answers section. These questions came from employees like you. We hope you find them helpful and informative.

Please let us know if you encounter any problems or have suggestions. If you don't find the answer to your benefits question, please contact us.

Basics:

1. Am I eligible for benefits?
2. Can I enroll my dependents?
3. When is my coverage effective?
4. When is Open Enrollment?
5. What is a qualifying event?
6. What happens to my benefits when I leave?

Plan Years:

1. I'm confused, what is the plan year for the Pioneer Educators Health Trust (PEHT) and when do my calendar year deductibles and annual out of pocket maximums renew?
2. How long do I have to submit my medical expenses or dependent care expenses to my Personal Choice Flexible Spending Account?

Prescriptions:

1. How much do prescription costs affect the total premiums?
2. Does using generics vs. brand-name prescription drugs really make a difference?
3. Besides using generic drugs and signing up for mail order, how else can I save money on my out-of-pocket benefit expenses?

Costs:

1. How much does the College pay for employee benefits?
2. What does the Fringe Benefits Committee do and who are the Committee members?

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Basics:

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Am I eligible for benefits?

You are eligible for the full benefit package if you are a faculty member with at least a .75 full-time equivalent (FTE) or a staff member who works at least 30 hours per week.

The full benefit package includes medical, vision, dental, life, AD&D, disability, flexible spending, and the retirement supplemental and annuity plans.

You are eligible for the partial benefit package if you are a staff member who works at least 20 hours per week or a faculty member with at least .50 FTE. The partial benefit package includes medical, vision, dental, flexible spending, and the retirement supplemental and annuity plans. If you are a adjunct faculty member with at least .50 FTE, you are eligible for the partial benefits package with the exception of the retirement annuity plan. Benefits are not extended to temporary employees.

Can I enroll my dependents?

Yes, you can enroll your spouse/domestic partner and your dependent children up to age 23 for medical and dental coverage. A signed affidavit is *required* to enroll spouse or domestic partner; please read this MEMO for more information.

When is my coverage effective?

Your effective date of benefit coverage is the first day of the month following your date of hire. For example, if your hire date is on September 8th, your benefits would begin on October 1st. In order for your benefits to become effective, you must complete and submit all of the required enrollment forms to the Human Resource Office with 31 days of your date of hire. Sadly, if your forms are not returned within your initial 31 days of employment, you will need to wait for the annual Open Enrollment period or a qualifying event to enroll in your benefits.

When is Open Enrollment?

The Open Enrollment for 2009 has closed. The next Open Enrollment opportunity will begin mid-February through mid-March 2010. Open Enrollment is a great time to take a look at your existing benefit plans, evaluate any anticipated needs and make adjustments for the upcoming plan year. To learn more about Open Enrollment benefit choices and how to make benefit changes, simply review the 2009 Open Enrollment Guide

What is a Qualifying Event?

A qualifying event is a change in your or your dependent's personal lives which may allow you to add, change or terminate some of your benefit elections. If you have experienced a qualifying event, you must notify us within thirty-one (31) days of the qualifying event date in order to make a change to your benefits. If the thirty-one (31) days have passed, you must wait until the next open enrollment period to make the change.

Examples of qualifying events:

1. Change in your marital or domestic partner status, including marriage or meeting the six (6) month requirement for domestic partnership, death of spouse/domestic partner, divorce or dissolution of partnership, legal separation, or annulment.
2. Change in the number of your dependents, including a change due to birth, adoption, or loss of dependent status (e.g., a child reaches the age limit under the plan, 23 yrs, or is no longer eligible as a dependent).
3. Change in your employment status, including a beginning or termination of employment, beginning or returning from an unpaid leave of absence, sabbatical, and a change to/from part-time employment.
4. Change in your spouse/domestic partner or dependent’s employment status, causing a gain or loss of health coverage for you or your dependent. Some examples are beginning or ending employment, increasing or decreasing hours, strike or lockout.
5. Changes associated with your spouse/domestic partner's open enrollment period, including changes in the type and cost of their coverage like a gain or loss of eligibility for you, your spouse/domestic partner, or your dependents.

How do I make changes to my benefits if I experience a qualifying event?

Please fully complete an enrollment form. It is very important that you clearly mark the reason for completing the form as well as each section. The information on the form will replace any previous enrollment form submitted by you. Your form is not complete until the printed and signed version has been received by the Human Resource Office within thirty-one (31) days of the qualifying event date. You will also need to provide the required documentation for your qualifying event in order for the change to be effective. We will accept a letter with the effective date from the new/former insurance company or another new/former HR department. A copy of a ID card is not sufficient proof of new insurance as the date the card is printed could be any point in the year, not the actual enrollment date.

Please contact us for more information about qualifying events, as this list is not inclusive of all qualified change in status events.

What happens to my benefits when I leave?

First, it is required that you notify Human Resources of your last day, then when you leave the College your benefits will be affected as follows:

Your health, dental, life, long-term disability, and AD&D coverages will end on the last day of the month in which you work your last day. For example if your last day is September 10th, your benefits will end on September 30th.

Your coverage under the health and/or dental plans may be continued in accordance with the Consolidated Omnibus Reconciliation Act (COBRA) of 1986, for up to 18 months (29 months if currently disabled and receiving Social Security Disability (SSD) or deemed disabled by SSD any time during the first 60 days of COBRA coverage) by paying a monthly premium. Your employee-paid and expanded life coverages may also be converted to an individual policy.

You will be sent a detailed informational letter, COBRA paperwork, and continuation forms to your home address when your coverage ends.

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Plan Years:

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