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Enrollment

You can enroll yourself and your family members in benefits plans at different times during the calendar year – as a new employee, if you experience a special qualifying event, or during open enrollment.

Enrolling in a plan (New Employees)

New Employees


 

As a new employee, your eligibility date is your hire date. You must complete enrollment within 31 days after your hire date. Coverage starts on the first day of the month after you complete one full calendar month of employment, except for voluntary term life insurance. Voluntary term life insurance will become effective after you have completed three full calendar months of employment.

Application must be made within 31 calendar days of the date of the status change, but you should submit your enrollment request as soon as possible to avoid the possibility of double premium deductions. You must be in a positive pay status on the day your coverage begins. If you do not enroll in health coverage by the end of your enrollment period you must wait for the annual enrollment period, unless you have a qualifying event during the year.

New Hire Forms

**The Enrollment change form should be submitted even if you are refusing coverage.

Questions and enrollment forms should submitted directly to mybenefits@uthsc.edu. Secure submission of your forms can be done via the UT Secure Emailing Vault System.

Dependent Eligibility


 

If you enroll in health, vision or dental coverage, you may also enroll your eligible dependents.

The following dependents are eligible for coverage:

  • Your spouse (legally married)
  • Natural or adopted children
  • Stepchildren
  • Children for whom you are the legal guardian
  • Children for whom the plan has qualified medical child support orders.
  • Dependent children are eligible for coverage through the last day of the month of their 26th birthday.
Dependent Verification Documents

Spouse:

  • Government issued marriage certificate or license AND one document proving proof of joint ownership.
  • Bank Statement issued within the last six months with both names. 
  • Mortgage Statement issued within the last six months with both names.
  • Residential Lease Agreement within the current terms with both names
  • Credit Card Statement issued within the last six months with both names
  • The first page of most recent Federal Tax Return filed showing “married filing jointly” (if married filing separately, submit page 1 of both returns) or form 8879 (electronic filing).

Child: Birth certificate.

 

To learn more about the health insurance options visit our benefits website: http://www.uthsc.edu/hr/benefits/

Special Qualifying Event

The federal law, Health Insurance Portability Accountability Act (HIPAA), allows you and your dependents to enroll in health coverage under certain conditions. Exceptions will also be made for you or your dependents if you lose health coverage offered through your spouse’s or ex-spouse’s employer.

You or your dependents may also be eligible to enroll in dental and vision coverage when lost with another employer. If you are adding dependents to your existing coverage, you and your dependents may transfer to a different carrier or healthcare option, if eligible. Premiums are not prorated. If approved, you must pay premium for the entire month in which the effective date occurs.

Identify the qualifying event(s) which caused the loss of other coverage for you and/or your eligible dependent(s).

Special Qualifying Events
  • Death of a spouse or ex-spouse
  • Divorce
  • Legal separation
  • Loss of eligibility (does not include loss due to failure to pay premiums or termination of coverage for cause)
  • Termination of spouse’s or ex-spouse’s employment
  • Employer ends total premium support to the spouse’s, ex-spouse’s or dependent’s insurance coverage (not partial)
  • Spouse’s or ex-spouse’s work hours reduced
  • Spouse maintaining coverage where lifetime maximum has been met
  • Loss of TennCare (does not include loss due to non-payment of premiums)

Adding Dependents

Application for enrollment must be made within 60 days of the loss of insurance coverage or within 60 days of a new dependent’s acquire date. 

If adding dependents to insurance for the first time, the following dependents are eligible for coverage: • Your spouse (legally married) • Natural or adopted children • Stepchildren • Children for whom you are the legal guardian • Children for whom the plan has qualified medical child support orders. 

Dependent children are eligible for coverage through the last day of the month of their 26th birthday.

*Required Documents: Written documentation from the employer or the insurance company on company letterhead providing the names of covered participants, date coverage ended, reason for the loss of eligibility and what coverage was lost (i.e., medical, dental, and vision).

You must also provide government issued marriage certificate or license AND one document proving proof of joint ownership along with providing the child’s birth certificate. 

Loss of Coverage

If enrolling due to loss of coverage under another plan, options for coverage start dates are: 

  • The day after the loss of other coverage or
  • The first day of the month following loss of other coverage
  • If enrollment is due to birth, adoption or placement for adoption, the day coverage date must be date of birth, adoption or placement for adoption
     

Please download the following enrollment form which details required documents- Health/Dental/Vision Enrollment Form

Questions and enrollment forms should submitted directly to mybenefits@uthsc.edu. Secure submission of your forms can be done via the UT Secure Emailing Vault System.

Canceling Coverage

You may only cancel coverage for yourself and/or your dependents if you lose eligibility or you experience an event that results in you/your dependents becoming newly eligible for coverage under another plan. There are no exceptions. You have 60 days from the date that you and/or your dependents become newly eligible for other coverage to turn in an application and proof to your agency benefits coordinator. The required proof is shown on the application.

 You may become newly eligible for other medical coverage if one of the follow events occurs:

  • Marriage, divorce, legal separation, annulment • Birth, adoption/placement for adoption • Death of spouse, dependent
  • New employment, return from unpaid leave, change from part-time to full-time employment (spouse or dependents)
  • Entitlement to Medicare, Medicaid or TRICARE
  • Court decree or order
  • Open enrollment
  • Change in place of residence or workplace out of the national service area (i.e., move out of the U.S.)
  • Marketplace enrollment

 Once your application and required proof are received, the coverage end date will be either:

  • The last day of the month before the eligibility date of other coverage
  • The last day of the month that the event occurred

You may request to cancel Prepaid dental if there is no participating general dentist within a 40-mile radius of your home. If you request to cancel disability coverage, 30 days advance written notice is required.

You must notify your agency benefits coordinator of any event that causes you or your dependents to become ineligible for coverage. You must repay any claims paid in error. Refunds for any premium overpayments are limited to three months from the date notice is received.

 When cancelled for loss of eligibility, coverage ends the last day of the month eligibility is lost. For example, coverage for adopted children ends when the legal obligation ends. Insurance continued for a disabled dependent child ends when he/she is no longer disabled or at the end of the 31-day period after any requested proof is not given.

Divorce — If you request to terminate coverage of a dependent spouse while a divorce case is pending, such termination will be subject to laws and court orders related to the divorce or legal separation. This includes the requirements of Tennessee Code Annotated Section 34-4-106 and the requirement that you provide notice of termination of health insurance to your covered dependent spouse under Tennessee Code Annotated Section 56-7-2366. As the employee, it is your responsibility to make sure that any request to terminate your dependent spouse is consistent with those legal requirements.

Insurance Cancel Request Application

Questions and enrollment forms should submitted directly to mybenefits@uthsc.edu. Secure submission of your forms can be done via the UT Secure Emailing Vault System.

Annual Enrollment Period
 

The Annual Enrollment Period is typically the first two weeks in October. The enrollment period gives you another chance to enroll in health, dental, vision, voluntary accidental death coverage, voluntary term life and disability insurance coverage. You can also make changes to your existing coverage, like increasing or decreasing voluntary term life insurance, transferring between health, dental, disability and vision options and cancelling insurance.

Most changes you request start the following January 1. However, voluntary term life and disability insurance may start January 1, February 1 or March 1. This is due to the review of medical history by the insurance carriers to determine your qualification for coverage.

Benefit enrollments remain in effect for a full plan year (January 1 through December 31). However, you may cancel disability and voluntary term life coverage at any time. You may not cancel other coverage outside of the enrollment period unless eligibility is lost or there is a qualifying change or event. 


Questions and enrollment forms should submitted directly to mybenefits@uthsc.edu. Secure submission of your forms can be done via the UT Secure Emailing Vault System.

Last Published: Aug 27, 2019