Benefits Plan Provisions and Eligibility

Eligibility

As defined in Section 3359 of the Rules of the University Board of Trustees, all full-time faculty, contract professionals and staff members are eligible to receive group insurance benefits. 

Employees must notify and provide documentation to the Office of Benefits Administration within 31 days to process a family status change. 

When insurance is effective

A full-time faculty, contract professional or staff member is eligible for insurance effective the first day of the month following appointment or date of hire. For example, if an employee is hired on August 20, their insurance benefits would begin September 1. If an employees is hired on September 1, insurance benefits would begin October 1. 

If the employee is absent from work on the day on which insurance would normally begin, insurance becomes effective the day the employee begins work or returns to active work. 

Documentation retired to certify dependent eligibility

The University of Akron's definition of an eligible dependent can be found below. If you are adding a dependent for the first time, proof of dependency is required at the time elections are made. Elections will not be processed until all required documentation is received by the Office of Benefits Administration. All required documentation must include date and/or year, employee name and dependent name. Please send documentation via campus mail to +0602 or email to benefits@uakron.edu.

Spouse

To certify spouse eligibility, provide copies of two forms of documentation listed below:

  • A copy of your marriage certificate AND
  • A copy of the front page of your most recently filed federal tax return confirming this dependent as a spouse, OR documentation dated within the last six months establishing current relationship status such as joint household bill, joint bank/credit account or joint mortgage or lease listing your name and your spouse's name

Children

A child is defined as your natural child, stepchild, legally adopted child, foster child, child under the age of 19 placed with you for adoption, child living with you for whom you or your spouse are custodian or legal guardian or a child for whom you are required to provide health insurance by a Qualified Medical Child Support Order (QMCSO). 

To certify child eligibility, provide the appropriate copy of the forms of documentation listed below:

  • A copy of the child's birth certificate, naming you or your spouse as the child's parent or appropriate court order/adoption decree naming you or your spouse as the child's legal guardian
  • If applicable, a copy of a court-issued Qualified Medical Child Support Order or other court order where you or your spouse are required to provide healthcare
  • Up to age 26 (coverage terminates at the end of the month in which they turn 26) children may be covered under your health plan as long as you provide documentation that they are your child (see requirements above). They can be married (there is no coverage for any dependents of the married child), they do not need to be residents of Ohio, they do not need to be students and they can have other health coverage available to them
  • Coverage may extend to any age for a dependent who is incapable of self-support due to a mental or physical disability, is wholly dependent on the employee for support and maintenance and lives with the employee in a normal parent-child relationship

When dependent insurance is effective

Each dependent will be insured beginning with the latter of:

  • The first day of the month following appointment or date of hire of the employee or the date of becoming an eligible dependent. A dependent confined to a hospital on the date of which insurance would normally begin will become insured on discharge from the hospital

When Insurance Terminates

Insurance terminates when the employee:

  • leaves the University's employment
  • is no longer eligible, or
  • when the group policy terminates

A dependent's insurance terminates when the employee's insurance terminates or when the dependent is no longer considered eligible.

Individual Termination: All coverage terminates on the last date of employment. 

9-month Employees: Benefits terminate for all employees on their last day worked. For 9-month faculty who have an end date at the end of the spring semester, a refund for overpayment of benefit contribution will be applied to reduce the employee's deductions on their last regular monthly paycheck in May. If notification is not received until after the May payroll is confirmed, a refund check will be mailed to the employee's home address. It is the responsibility of the employee to notify the Office of Benefits Administration of any changes in address or contact information. In the event that the faculty member is teaching in the summer, their benefits will be extended and terminate on the last day of their summer appointment. If the faculty member is being renewed for the fall semester, their benefits will not terminate and will be extended until the following fall semester. 

Temporary Layoff: All coverage except Long-Term Disability will be continued for up to 4 months.

Permanent Layoff: All coverage terminates on the last day of employment. 

Leave of Absence: Any employee in a full or partial approved leave of absence continues benefits for up to one year.  

Military Leave of Absence: Please refer to University Rule 3359-11-05.

Total Disability: All coverage except life insurance terminates at the earliest of the following measured from the date of disability,

  • A period of time equal to prior service
  • When the employee becomes eligible for Medicare or Ohio Retirement Systems benefits
  • Two years

Surviving Spouse and Insured Dependents of Deceased Active Employees: All group benefits terminate on the last day of the second month following the month of death. For example, if an employees dies on March 2, benefits for dependents will terminate on May 31.

Retired Employees: All coverage terminates on the last day of employment.

Arrangements may be made for continuation of coverage for the employee or eligible dependents under COBRA.


Family Status Change Policy

An employee may revoke an election to all group benefits (except Long-Term Disability) during a period of coverage commitment and make a new election due to a change in family status. Events qualifying as a change in family status are defined as:

  • Legal marital status
  • Residence (moving in/out of the United States for 6 consecutive months)
  • Entitlement to Medicare, Medicaid, or other insurance (ie: spouse’s open enrollment)
  • Employment status (covered employee and dependent including starting employment ending employment, full to part-time status, or part to full-time status)
  • Dependent satisfies or ceases to satisfy eligibility requirements
  • Significant cost or coverage changes (25% increase or decrease)
  • Number of dependents (birth, death, adoption, marriage, divorce, etc.)
  • Judgment, Decree or Order

All changes in family status must be reported and forms completed and returned within 31 days of the event. If an employee fails to complete a change in family status within 31 days of the event, the employee will be able to make changes at their next family status change or the next open enrollment period.

Family Status Changes require documentation of the event. Employees incurring a change in family status should contact The Office of Benefits Administration at 330-972-7090.


Working Spouse Rule

The University's Working Spouse policy requires spouses of University employees who have access to employer subsidized (at least 50%) medical and dental insurance to elect that coverage as primary. These spouses are only permitted to have secondary access to University medical and dental policies.

For additional information, employees should contact the Office of Benefits Administration at 330-972-7090 or benefits@uakron.edu