BOWLING GREEN STATE UNIVERSITY


It’s health care open enrollment time

The annual open enrollment period began Oct. 24 for the plan year beginning Jan. 1, 2006. Packets of information began arriving at homes on Oct. 21. If you have not received your packet, the information for open enrollment can be found on the Office of Human Resources Web site at http://www.bgsu.edu/offices/ohr/benefits/index.html.
The Health Care Enrollment and Change form can be obtained at Human Resources.

If you do not receive your packet by Oct. 27, contact Human Resources.

All full-time administrative and classified staff and faculty members must complete a BGSU Health Care Enrollment and Change Form even if they choose not to accept coverage.

The spousal working rule goes into effect Jan. 1 for all staff. If your spouse is working full time and his or her employer offers group health care coverage and subsidizes at least 70 percent of the coverage, you cannot cover your spouse as a dependent unless he or she is also enrolled in the employer’s group health plan. A “Working Spouse Form” must be completed and returned if you are covering a working spouse. This form is to be completed by the spouse’s employer documenting the spouse’s employment status and the employer’s health care coverage option, subsidization and open enrollment period. (Dependent children are not required to be enrolled in your spouse’s plan to be eligible under the BGSU plan.)

The following are frequently asked questions about the spousal working rule.

Q. How is BGSU going to verify if someone’s spouse can get health insurance from his or her employer and that the employer pays 70 percent of the health care premium?

A. There is a form called the “Working Spouse Form” that will need to be completed and returned to the BGSU Office of Human Resources by Nov. 18. Part of the form is completed by the BGSU employee and the rest must be completed by the spouse’s employer. The spouse’s employer’s human resource department (or department responsible for benefits) must complete the questions that deal with whether the BGSU employee’s spouse is full time and if the employer pays at least 70 percent of the cost of the health care coverage.

BGSU’s Office of Human Resources has been completing similar forms for many employers of our employees’ spouses.

Q. How do I know if my spouse’s employer pays at least 70 percent of the health care premium?

A. Some employers may not share the entire cost of the health care coverage in their open enrollment documents. Therefore, the Working Spouse Form asks the spouse’s employer to provide information about the cost of the plan for both the employer and employee.

Q. What does it mean when it says “the spouse’s employer must pay at least 70 percent of the health care plan cost?”

A. An example:
The monthly cost is $400 for single coverage.
70 percent of $400 = $280 (this is the amount that the employer would pay per month)

If the spouse’s employer pays less than 70 percent, in this case less than $280 a month, then the spouse is not required to enroll in the employer’s health care plan.

Q. Must an employee’s spouse take his or her employer’s health care plan or can the spouse just stay on BGSU’s plan?

A. If the BGSU employee’s spouse works full time and the employer offers a health care plan and pays at least 70 percent of the cost of that plan, the spouse must take coverage with his or her employer. BGSU employees may keep their spouses on the BGSU plan as secondary if they choose.

If the spouse’s employer offers more than one plan option to choose from and the employer’s cost varies with each plan, as long as one plan option is paid by the employer at least 70 percent, then the spouse must be covered by one of the employer’s plans to be eligible to be covered secondary on the BGSU plan.

Q. When will this spousal rule go into effect at BGSU?

A. The spousal rule goes into effect Jan. 1, 2006. Since this is a potentially life-changing event, the spouse’s employer should allow for election into the employer’s plan effective Jan. 1. If that is not possible, the Office of Human Resources will be in contact with your spouse’s employer as long as the Working Spousal Form is completed and returned to BGSU’s Office of Human Resources by Nov. 18.

Q. What happens if a BGSU employee’s spouse is now covered by his or her employer’s plan and loses coverage? Can the spouse join BGSU’s health care plan?

A. If the spouse is covered under BGSU as a secondary plan, a letter from the spouse’s employer explaining why the spouse lost coverage and the effective date of losing that coverage will be needed. Once this is received, then the BGSU plan will become primary. If the spouse is not covered by the BGSU plan and loses coverage, he or she can become covered under the BGSU plan with a letter from the employer noting the reason for the loss of coverage and the date that coverage was lost. The BGSU employee will then need to complete an enrollment form adding the spouse to the coverage. If a spouse loses coverage, he or she must be added to the BGSU plan within 30 days of the loss.

Q. What will I need to do if my spouse is currently working part time but during calendar year 2006 gets a full-time job?

A. At that time, the BGSU employee must report it to the Office of Human Resources and complete and return the BGSU Spousal Working Form. If your spouse works part time now, he or she does not fall under the requirement to enroll in the employer’s health care plan. However, if the spouse’s job becomes full time at any point during 2006 and the employer pays at least 70 percent of the health care coverage cost, the spouse would then fall under the requirement to be covered under the employer’s plan.

October 31, 2005