GENERAL PLAN PROVISIONS
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.
When Insurance is Effective
A full-time faculty, contract professional or staff member is eligible for insurance effective on the date of appointment or date of hire.
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.
Who Are Eligible Dependents
If an employee is insured, eligible dependents may be:
- spouse, unless legally separated,
- unmarried children under age 19, and children who are 19 years of age until the end of the month after reaching age 25 provided they are unmarried, dependent, full-time students.
the term "spouse" refers to individuals who have contracted the legal status of a marital relationship through religious or civil solemnized marriages and complied with all the statutory requirements pursuant to applicable law; and shall not include common law marriages which may be otherwise recognized under Ohio law or other relationships between persons not legally capable of making a marriage contract under Ohio law.
the term "children" includes stepchildren and foster children who are wholly dependent upon the employee for support and maintenance and live with the employee in a normal parent-child relationship.
if the child is developmentally disabled or physically handicapped, insurance may be continued under the circumstances described in the group policy. Benefits Administration must be notified within 31 days before termination of the child's insurance to continue coverage.
When Dependent Insurance is Effective
Each dependent will be insured beginning with the latter of:
the effective date of appointment or hire, three months following the date of becoming an eligible dependent - in the case of a dependent child acquired other than by birth, legal adoption or marriage, or
the date of becoming an eligible dependent - in the case of any other dependent.
- A dependent confined to a hospital on the date on which insurance would normally begin will become insured upon discharge from the hospital.
When Insurance Terminates
Insurance terminates when the employee
leaves the University's employ,
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. In cases where a dependent student is required to drop classes due to the occurrence of a disabling condition, coverage will be continued up to 12 months.
Individual Termination - all coverage terminate on the date of termination, except for group life insurance protection, which continues for 31 days.
Temporary Layoff - All coverage except for Long-Term Disability will be continued for up to four months.
Permanent Layoff - All coverage terminate on the last date of employment.
Leave of Absence - Any employee on 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 terminate 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 System benefits,
or 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.
Retired Employees - Insurance coverage (except for life insurance) terminates for recipients of Ohio Retirement System benefits. For employees hired before January 1, 1992, comprehensive medical coverage for dependents of Ohio Retirement System retirees continues if:
the 9-month faculty retiree had ten consecutive academic years, contract professionals and staff had ten calendar years of full-time service with the University immediately prior to retirement, and
the dependent was eligible for insurance when the retiree's health insurance coverage terminated.
Arrangements may be made for continuation of coverage for the employee or eligible dependents under COBRA.