Health Care Plans

Revision date of this archived policy: July 11, 2002

Note: This is not a current version of the policy. View current version. »

93.1	Policy
	The University makes various health care plans available to certain regular employees, certain temporary employees, certain retirees, and others as designated by the Administrative Regulations.
	93.1.1	The University health care plans are self-funded. The plan document, entitled "University of Kentucky Medical Benefits Plan", is available in the Employee Benefits Office and on-line.
	93.1.2	The University offers several health care plans. All plans are not available in every location. The employee's county of residence normally determines plan availability. The details of each health care plan are contained in a certificate of coverage or summary plan description. Copies of the certificates of coverage are available in the Employee Benefits Office.
NOTE: Since alternatives, coverage, and administrators of the plans may change from time to time, it is recommended that an employee study and evaluate the detailed brochures of each plan prior to enrollment.
	93.1.3	The University contributes a health care plan credit amount toward the cost of the monthly health care premium for enrolled regular, full-time employees (see HRP&P 94.0: Health Care Plan Credit).
		93.1.3.1	Additional cost for the health care plan in which the employee enrolls shall be paid by the employee.
	93.1.4	Generally, an eligible employee may enroll in a health care plan available where the employee resides.
		93.1.4.1	An eligible employee may enroll in one of the following levels of coverage: 1) Employee only, 2) Employee + child(ren), 3) Employee + spouse, or 4) Employee + family. 93.1.4.1.1 Coverage for new enrollment shall be effective on the first day of the month following receipt of the enrollment application by the Employee Benefits Office. 93.1.4.1.2 Enrollment may occur at the following times: within the initial thirty (30) days of employment, 2) during periods of open enrollment, or 3) within thirty (30) days of a qualifying family status change.
NOTE: A family status change occurs because of one of the following events: a) you get married or divorced, b) you have a child through birth or adoption, c) you lose coverage under another plan, d) you must comply with a family relations judgment, decree or order, e) you or your spouse change your employment status from full-time to part-time or vice versa, f) you or your spouse end or being work, and g) your spouse’s coverage changes during his/her open enrollment. You have thirty (30) days from the date of the family change of status to return your completed enrollment form(s) to the Employee Benefits Office. Any changes you make must be consistent with the family status change and will require documentation such as birth, marriage, or death certificates.
			93.1.4.1.3 A change in enrollment will be effective as of the date of the qualifying event. 93.1.4.1.4 Eligible dependents include spouse, unmarried children less than nineteen (19) years of age, and unmarried children between nineteen (19) and twenty-five (25) years of age who continue to be dependents and full-time students. Eligibility for a spouse or dependent(s) is defined in the plan's certificate of coverage. 93.1.4.1.5 For active employees who are eligible for Medicare (e.g., age 65 or older), the selected University of Kentucky health care plan provides primary coverage and Medicare is supplemental. 93.1.4.1.6 Health care plan participants who receive medical benefits through the University’s long-term disability plan and who are eligible for Medicare Part B shall apply for Medicare Part B benefits through the Social Security Administration. Upon approval for Medicare Part B, the participant shall change enrollment from a current health care plan to a carveout plan which provides benefits secondary to Medicare.
	93.1.5		Temporary employee eligibility is contingent upon the following: 93.1.5.1 The employee shall have an assignment for at least six (6) months. 93.1.5.2 The employee shall be at least a .20 full time equivalent (FTE), and 93.1.5.3 The employee shall have sufficient earnings to pay the monthly premium of the plan in which the employee is enrolled.
	93.1.6	Retiree eligibility for participation is contingent upon the following: Retirement in accordance with University retirement regulations (AR-II-1.6); and A minimum of five (5) years of regular full-time employment or its equivalent at the time of retirement and, at the date of retirement, participation in a plan.
		93.1.6.1	At the time of retirement, and thereafter, the retiree may not add dependents to a health care plan unless the retiree experiences a qualifying event (i.e., marriage, birth, or adoption of a child). A change of enrollment shall be made by the retiree within thirty (30) days of the occurrence of the qualifying event.
		93.1.6.2	A retiree who is eligible to participate in a University health plan and who has been continuously enrolled in a University health plan, may add a spouse at the time the spouse terminates University employment if the spouse has been a regular full-time University employee for five (5) years or more. The spouse who is not eligible to retire must have been a regular full-time employee on the date the other spouse retired, must be enrolled in a University health plan at the time of termination, and must be in continuous employment at the University until added to the retiree’s plan.
	93.1.7	Retiree participants who become eligible for Medicare Part B shall apply for Medicare Part B and upon acceptance into Medicare Part B shall change current coverage to a carveout plan.
		93.1.7.1	Generally, retiree carveout plans are coordinated with Medicare Parts A and B coverage. Medicare is primary coverage and the carveout plan is secondary coverage.
		93.1.7.2	For retirees who return to University employment through fee schedule employment or on a post-retirement appointment and who are .20 or greater FTE, the University plan is primary and Medicare is supplemental.
		93.1.7.3	Anyone hired prior to April 3, 1997, who has a minimum of fifteen (15) years of regular full-time employment or its equivalent, shall receive a health plan credit as a retiree.
		93.1.7.4	Anyone hired on or after April 3, 1997, who has a minimum of (15) years of continuous regular full-time service or equivalent, shall receive a health plan credit as a retiree. The fifteen (15) years of continuous regular full-time service or equivalent shall be immediately prior to the date of retirement.
		93.1.7.5	Retirees under the age of sixty-five (65) who become disabled are eligible for Medicare Part B and shall apply for a carveout plan.
	93.1.8	In the event of the death of an employee who is not eligible for retirement, eligible dependents may continue coverage in the plan in accordance with the federal law, Consolidated Omnibus Reconciliation Budget Act (COBRA).
		93.1.8.1	In the event of death of an employee who is eligible to retire under AR II-1.6 at the time of death, eligible dependents shall be eligible for continued coverage in accordance with the provisions of 93.1.6 and 93.1.7. 93.1.8.1.1 The spouse and dependents shall have been enrolled in a University health plan at the time of the employee’s death.
93.2	Delegation
	Administration of the University’s health care plans is a function of the Employee Benefits Office.
93.3	Procedure
	93.3.1	An employee seeking information about health care plans or desiring to enroll shall refer to current brochures or contact the Employee Benefits Office. Eligible community college employees wishing to enroll in one of the health care plans may obtain current brochures and/or enrollment forms from the business officer or the president's office at the college where they are employed or the KCTCS administrative offices. 93.3.1.1 All enrollments are processed by the Employee Benefits Office.
	93.3.2	Premium payments for an employee in a pay status shall be made through payroll deductions.
		93.3.2.1	An employee who is going to be in a no pay status and who is enrolled in a health care plan shall make arrangements with the Employee Benefits Office to pay the plan's premiums or coverage terminates.
	93.3.3	Generally, the employee's premium contribution is paid under Internal Revenue Service Code Section 125 on a pre-tax dollar basis.
	93.3.4	An employee who loses eligibility for coverage because of termination of employment is eligible to continue coverage for a period as defined by federal law (Consolidated Omnibus Budget Reconciliation Act or COBRA) at the employee's own expense.
		93.3.4.1	Information explaining the costs, billing procedures, and maximum coverage period shall be sent to persons eligible for COBRA rights by the Employee Benefits Office.

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