EFFECTIVE JULY 1, 2013
An employee must complete and return all applicable insurance forms in a timely manner before insurance coverage will begin Insurance coverage for new employees will begin on the first contract day worked if worked between the 1st and the 10th of the month. If an employee’s first contract day worked is after the 10th of the month, the insurance coverage will begin on the 1st day of the month following employment. Each employee is responsible for his or her portion of the H&A insurance premium through a flex-spending payroll deduction in accordance with negotiated agreements with employee groups.
1. Patient Protection and Affordable Care Act (PPACA):
The District will establish its Standard Measurement Period starting on July 1 of each year and going through June 30. The Administrative Period will run concurrently from July 1 to August 31 and the Standard Stability Period will run from September 1 to August 31 of each year. The District will use a 12-month look back period to determine eligibility for medical insurance benefits. Eligibility for benefits will be calculated under the PPACA guidelines of 30 hours or more average per week or 130 hours average per month. “Hours” for these purposes include all hours for which the employee is paid (including holidays, sick leave and vacation), and also include unpaid leaves of absence if qualified under FMLA or military leave under USERRA.
2. MEDICAL
2.1 Medical coverage is available for all full-time contracted District employees who work (at least 37.5 hours per week), their spouse and dependents. All current contracted employees who are presently enrolled in health insurance coverage and do not meet the new hours per week criteria, will be “Grandfathered In” and will retain the opportunity to keep medical coverage. If a current contracted employee meets the existing coverage criteria and is not enrolled in health insurance coverage as of July 1, 2013, they must now qualify under the new policy guidelines.
2.2 Medical coverage for the employee only will be available for classified contracted employees who work 30 hours or more per week and for certified contracted employees who work in a 0.75 FTE position or higher in accordance with the “Affordable Healthcare Act”. This classification of contracted employee may purchase coverage for their spouse and dependents through a flex-spending payroll deduction. Employees who are contracted to work less than 30 hours per week are not eligible for either individual or family coverage through the District. All current contracted employees in this classification who are presently enrolled in the employee coverage of health insurance and do not meet the new hours per week criteria, will be “Grandfathered In” and will retain the opportunity to keep medical coverage. If a current contracted employee meets the existing coverage criteria and is not enrolled in health insurance coverage as of July 1, 2013, they must now qualify under the new policy guidelines.
3. Retired Employee’s Option to Purchase H&A Insurance
3.1 After retirement, an employee eligible under this policy may purchase H&A insurance through the District from the District’s insurance provider at the established rates applicable for retirees of the District, subject to the following limitations:
3.1.1 The employee must be eligible to retire immediately under the Utah State Retirement system to be eligible for this benefit, and must in fact retire under the Utah State Retirement system.
3.1.2 The employee must have been eligible under policy #2101 – Defined Medical Benefit for the immediately preceding ten years before retirement.
3.1.3 As determined by the policies of the District’s health insurance provider, the employee may only purchase H&A insurance through the District from the District’s Insurance provider until he or she becomes eligible for Medicare.
3.1.4 Any break in insurance coverage with the District’s insurance provider’s coverage through the District will render the retired employee thereafter ineligible to purchase H&A insurance coverage through the District from the District’s insurance provider.
4. LIFE
Term life insurance will be provided for all contracted District employees (who work at least 37.5 hours per week) and their dependents. The coverage will be according to the current life insurance contract policy limits as defined by the carrier. All current contracted employees who are presently enrolled in term life insurance coverage and do not meet the new hours per week criteria, will be “Grandfathered In” with their existing coverage.
5. LONG TERM DISABILITY
Long-term disability insurance is available for all contracted District employees that working 30 hours or more per week. The coverage will be according to the current long-term disability contract policy limits as defined by the carrier. All current contracted employees who are presently enrolled in long-term disability insurance coverage and do not meet the new hours per week criteria, will be “Grandfathered In” with their existing coverage.
Effective July 1, 2011, the District will not cover any retirement contributions for Tier II Utah Retirement System members under the long-term disability insurance.
6. WAIVER OF PREMIUM
The waiver of premium benefit will be according to the current Health and Accident insurance contract policy limits as defined by the carrier.
The employee's Group Life Insurance premium will be according to the current life insurance contract policy limits as defined by the carrier.
Approved 08/09/90
Revised 01/04/96
Revised 09/10/02
Revised 07/26/06
Revised 09/14/11
Revised 05/22/13
Revised 03/15/17
Revised 06/15/18
Revised 08/08/18