GENERAL PLAN PROVISIONS

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 with 31 days in order to process a family status change. 

When Insurance is Effective

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

Who Are Eligible Dependents

If an employee is insured, eligible dependents may be:

• Spouses
  -Defined under Chapter 3101 of the Ohio Revised Code
  -Subject to Spouse/Partner Eligibility Rule (Working Spouse Rule)
• Same Sex Domestic Partners
  -For more information , please see the University’s Same Sex Domestic Partner Affidavit
  -Subject to Spouse/Partner Eligibility Rule (Working Spouse Rule)
• Children under age 26
  -Children includes biological children, adopted children, stepchildren and foster children under the age of 26.
  -If the child is developmentally disabled or physically handicapped, insurance may be continued after age 26 under the circumstances described in the group policy.
• Adult Children (Medical & Prescription Coverage Only)
  -Adult Children include biological children, adopted children, and step children who are between age 26 & 27.
  -Adult Children must meet one of the following rules:
    Must not have access to any other group coverage
    Be a resident of the State of Ohio, or
    Be a full-time student if not residing in Ohio 

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, the date of becoming an eligible 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. 

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. For example, if an employee dies on March 2, benefits for dependents will terminate on May 31.

Retired Employees - Insurance coverage terminates for recipients of Ohio Retirement System and Alternative Retirement Plan 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.

The University of Akron 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 six 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 330-972-7092.

Spouse/Partner Eligibility Rule

Details and Original Announcement

Working Spouse Form (Primary Coverage Spouse Certification)

The University of Akron is implementing a new insurance eligibility rule for spouses and same sex domestic partners effective January 1, 2012. 

A working spouse policy requires spouses of university employees who have access to employer subsidized (at least 50%) medical and dental insurance will only be permitted to have secondary access to university medical and dental insurance policies. 

For additional information, employees should contact SummaCare 800.753.8429 or The Office of Benefits Administration at 330.972.7092 or benefits@uakron.edu

Same Sex Domestic Partner Enrollment Paperwork

1. Affirmation of partnership document
2. Declaration of tax status document
3. Affirmation of termination document