Support Staff Policies & Procedures

Support Staff Health Care Coverage Policy & Procedure

Last Updated October 25, 2019

Policy

The University provides access to health care coverage for eligible employees.

Eligibility and Effective Date of coverage: 

Regular full-time and part-time (50-89.9%) support staff; faculty, academic staff and executive management with appointments of nine months or more.

• Faculty, Academic Staff and Executive Management: Coverage is effective upon hire, provided enrollment occurs within 30 days of employment. If enrollment occurs within the first 30 days of employment, coverage will be retroactive to the date of hire.
• Support Staff: Coverage will become effective the first day of the month following the date of hire, provided enrollment occurs within 30 days of employment.  If enrollment occurs within the first 30 days of employment, coverage will be retroactive to the first day of the month following the date of hire. 

Immediately Eligible.   A non-regular benefit-eligible employee expected to be paid an average of 30 hours of service per week for at least 90 days, at the time of being newly hired or appointed. If the employee at any point within the first year of hire is expected to be paid 30 hours of service per week or more for 90 days or longer due to a change in assignment or status, then

• Coverage will be effective the first of the month following the date of hire, or if due to a status change, the first of the following month.

Variable Hour.  Newly hired or rehired (after a break greater than 26 weeks). A one-year measurement period applies effective the first of the month following the date of hire or rehire and coverage must be offered only if the employee is paid an average of 30 hours of service per week over the measurement period.  Temporary employees, on-calls, project pay and student employees will need to be measured in most cases.

• For variable-hour employees who qualify for coverage on the basis of hours of service paid during the initial measurement period, coverage will be effective no later than the first day of the month following 12 months of employment. Employees will be notified of their eligibility to enroll in the MSU-designated health plan within 30 days following the end of the 12-month initial measurement period with coverage retroactive to the first day of the 13th month, provided that enrollment occurs within 30 days of said notification.
• For those variable-hour employees who qualify for coverage on the basis of hours of service paid during a standard measurement period (SMP), coverage will become effective no later than the first day of the new plan year. Employees will be notified of their eligibility to enroll in the MSU-designated health plan within 30 days following the end of the standard measurement period with coverage retroactive to the first day of the new plan year, provided that enrollment occurs within 30 days of notification.

Summary of Benefit

Coverage may be selected by the employee for self and eligible dependents. Married couples and Other Eligible Individuals who both work at MSU and/or who are MSU retirees may cover themselves and any eligible dependents under one MSU health plan.

Health care coverage is available through one of the following health plans: (Prescription drug coverage is automatic when enrolled in any of the health plans.)

Regular part-time, full-time support staff, faculty/academic staff and executive management:

• Community Blue (preferred provider organization);
• Blue Care Network (health maintenance organization)

Regular part-time, full-time non-union support staff, faculty/academic staff, executive management, UNTF members, and immediately eligible and variable-hour employees:

• Consumer-Driven Health Plan with a Health Savings Account (HSA).

Dependent Access to MSU Health Plan Coverage:

• To be covered by an MSU health plan, spouses or Other Eligible Individuals of MSU employees who have access to coverage through their employer must purchase coverage through the other group plan if his/her annual premium contribution toward that coverage is as follows:

Year Effective	Spouse's Premium Contribution
Beginning in 2019	$1,300 or less
Beginning in 2020	$1,400 or less
Beginning in 2021	$1,500 or less

The MSU health plan would pay eligible claims for spouses/OEI’s as the secondary plan.  (VARIES: Dependents who have health coverage through another employer are not eligible to be enrolled in the CDHP with an HSA, they are only eligible for the CDHP.)

• Dependent unmarried children incapable of self-support due to mental or physical disability may remain covered under the basic family contract under Michigan Public Acts 274 and 275; however the disability must have been diagnosed by a physician prior to age 19.

Premium contribution:

• Health care premiums may be adjusted annually.
• Faculty, Academic Staff and Executive Management:
  • Full-time faculty, academic staff and executive management will contribute 14% of the premium cost for the lowest cost plan. If enrolled in a plan other than the lowest cost plan, the employee will contribute 14% of the premium cost for the lowest cost plan, plus the premium difference between the lowest cost plan and higher cost plan.
• Support Staff:
  • Full-time employees (90 – 100%): The University contributes 100% of the monthly premium for the lowest cost health plan for the employee and covered dependents. For those enrolled in a higher cost plan, the employee will contribute the difference between the two plans.
  • Part-time employees: The University contributes 50% of the monthly premium for the lowest cost health plan for employees with regular appointments of half-time (50 – 64.9%) and 75% of the amount for employees with regular appointments of ¾-time (65 – 89.9%). If enrolled in a plan other than the lowest cost plan, the employee will contribute the balance of the premium cost for the lowest cost plan (50% or 25%) plus the premium difference between the lowest cost plan and the higher cost plan. (VARIES: Flexible appointees receive a full-time University contribution.)
• Variable-hour employees: The employing Departments contribute 93% of the single subscriber monthly premium for the CDHP. If enrolling dependents in the CDHP, the employee will contribute 7% of the premium cost for single coverage, plus the full difference between single coverage and the selected level of coverage.
• Contributions paid through payroll deduction will be taken on a pre-tax basis.
• Employees in all categories must pay the full cost of any additional dependent rider.

Health Care Waiver:

• If employees are covered by health care coverage through another health plan, they are eligible to waive their MSU health care coverage upon hire, upon becoming eligible for coverage and/or during open enrollment and receive up to a $600 cash payment. (Retirees and employees whose spouses or Other Eligible Individuals are employed at MSU are not eligible for the waiver option.) The normal waiver period is January 1 through December 31, with payment to be received the following February. 
  
  • The cash payment is considered taxable income.
  • If other coverage is discontinued, the employee has 30 days to enroll in an MSU health care plan with the waiver payment prorated.
  • Individuals who have been terminated, or are going on unpaid leave of absence, or retiring will receive a prorated payment based on period of active employment during the waiver period.
• Individuals accrue points based on their employment percent and the number of months they are enrolled in the waiver: 1 point for each month in waiver if full-time; .75 for 3/4-time or .5 if half-time. See chart below.

Eligible employees who did not have other health care coverage during open enrollment, but have subsequently acquired other health care coverage, can enroll for the waiver option within 30 days of acquiring the other health care coverage. Examples of acquiring other health coverage include: the acquisition of Medicare, Medicaid or eligibility for premium assistance through the Medicaid program, acquisition of health coverage due to a change in employment status (e.g., new job), a change/revocation due to acquisition of health coverage through the employer of a spouse where the other employer’s open enrollment varies from MSU’s.  The waiver is effective the first of the month following the date the waiver application is received in MSU Human Resources.

Procedure to enroll or waive coverage:

• Enroll or waive coverage within 30 days of initial employment or 30 days if appointed to an eligible status by accessing the EBS Portal. (VARIES: Variable-hour employees who are determined to be eligible for coverage through satisfying the hours of service paid criteria during a measurement period must enroll or waive coverage within 30 days of notification of eligibility.)
• If enrollment does not occur within 30 days of initial employment, or 30 days of either appointment to an eligible status or determined to be eligible through satisfying a measurement period, it is necessary to wait for an annual open enrollment period, except as described below.
• During annual open enrollment, eligible employees may:
• waive coverage;
• enroll in a health plan for which they are eligible;
• change carriers;
• add eligible dependents;
• remove dependents.

Changes that may be made outside of Open Enrollment:

• Loss of coverage:  Eligible employees and/or their eligible dependents previously covered by a non-MSU sponsored plan may enroll within 30 days of loss of other group coverage. Coverage is effective the first of the month following enrollment. 
• Birth/adoption:  Eligible dependents may be added within 30 days due to birth or adoption or placement for adoption. A copy of the birth certificate or legal adoption documents is required. Coverage is effective retroactively to the date of birth or adoption.  The employee may also change benefit options if other options are available. 
• Change in dependency or custody:  Eligible dependents may be added within 30 days due to change in dependency or custody. Appropriate documentation is required. Coverage is effective no later than the first day of the first month after the date the completed request for enrollment is received.
• Marriage:  Eligible dependents may be added within 30 days of marriage.  A copy of the marriage certificate is required.  Coverage is effective no later than the first day of the first month beginning after the date the completed request for enrollment is received. The employee may also drop MSU-sponsored health coverage as a result of marriage, or change benefit options if other options are available.
• Change in employment status:  Employees who experience a change in status (full-time to part-time or part-time to full-time) can newly enroll within 30 days of the status change. Employees who are already enrolled and subsequently experience a status change can change health plans within 30 days of the status change.
• Obtaining other health coverage:  Employee’s and/or their eligible dependents may cancel or be removed from an MSU sponsored health plan within 30 days of the event.  The employee must actually be covered under the other plan. The effective date of the change is the first of the month after the request is received. [See above for comments regarding specifying the “other health coverage” to which this rule applies.]

Termination date of benefit:

• Health care coverage will cease at the end of the month of layoff or termination of employment for reasons other than official retirement from the University.
• Employees on unpaid leave of absence for reasons other than those under the FMLA receive no University contribution (VARIES: Flexible appointees see Policy and Procedure for flexible appointments;
• Employees on unpaid family and medical leave (FMLA) continue to receive the University contribution.
• Employees on unpaid leave of absence who wish to maintain coverage must forward the full premium to MSU Human Resources. Coverage allowed to lapse, due to non-payment of premiums, will automatically be reinstated to the coverage in effect prior to the leave for employees who return to an eligible status.
• Dependent coverage terminates as above. In addition, certain changes to dependent status terminate coverage for dependents, i.e., end of the year in which the dependent turns age 26.
• When an Affidavit of Termination of Other Eligible Individual partnership form has been filed, the coverage terminates the date the OEI criteria is not met. 

COBRA continuation of coverage:

In accordance with the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), group health care coverage for eligible employees and their dependents may be continued in the following situations:

• Upon termination of employment (except gross misconduct) or transfer to an ineligible status, employees and/or covered dependents may elect to continue group health care coverage for a period of up to 18 months (29 months if disabled and receiving Social Security Disability) by paying the applicable premium plus an administrative fee. An additional 18-month extension may be available if the covered dependent is actually enrolled during the initial COBRA coverage period and another event occurs that is the former employee’s death, divorce, legal separation or a dependent’s loss of eligibility due to age or loss of IRS dependency.
• If no termination of employment occurs, additional events that allow spouses and dependents to elect COBRA include: the employee's death, divorce, legal separation or a dependent's loss of coverage due to age or loss of IRS dependency; dependents may elect to continue group health care coverage for a period of up to 36 months by paying the applicable premium plus an administrative fee.

COBRA coverage must be elected in writing to MSU Human Resources by the eligible employee or dependent within 60 days of the date of the COBRA notice, or a loss of coverage will occur. The effective date of coverage and premiums payment calculations will be effective back to the date of loss of eligibility as an active employee.

Affidavit of Termination of Other Eligible Individual partnership:  

When an Affidavit of Termination of Other Eligible Individual (OEI) Partnership form has been filed, the coverage will cease on the date the OEI criteria is no longer met. MSU Human Resources staff sends the non-MSU employee/retiree Other Eligible Individual (and eligible dependents) continuation of coverage information. If continuation of coverage is elected, MSU sends monthly billing information for payment of premiums to the non-MSU employee/retiree (and eligible dependents).

Conversion of coverage:

• BCN and Community Blue coverage may be converted to an individual policy upon separation by directly contacting the carrier and applying for coverage within 30 days of termination of coverage. CVS Caremark (prescription drug coverage) cannot be converted to an individual policy.
• Those who are enrolled in BCN or Blue Cross Blue Shield of Michigan and select COBRA coverage upon separation and are enrolled in BCN or Blue Cross Blue Shield of Michigan may convert to an individual policy after maintaining the COBRA premium for the maximum coverage period (18 or 36 months, 29 months if disabled and receiving Social Security Disability). Coverage may be converted by directly contacting the carrier and applying for coverage within 30 days of termination of coverage.

Refer questions to:

MSU Human Resources via telephone at 517-353-4434 or email at SolutionsCenter@hr.msu.edu.

Revision history: 


7/9/2015 - policy re-written to include ACA provisions

1/18/2016 - enrollment period changed from 60 to 30 days except for COBRA

5/17/2016 - Removed reference to Employee Self Service (ESS) portal.

10/25/2019 - updated plan information

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