HEALTH, DENTAL AND OPTICAL INSURANCE BENEFITS. The Foundation shall offer at least two (2) types of health insurance plans to eligible employees, both of which shall provide hospital, medical, prescription drug and vision coverage. The health insurance plan coverage(s) currently available to eligible employees covered by this Agreement include individual; employee and spouse or domestic partner; parent and child(ren); and family. Specific plan details are set forth in the Summary Plan Description(s) provided by the Foundation. Full time employees who are appointed for at least four (4) complete consecutive calendar months are entitled to a choice of health insurance coverage: individual; employee and spouse or domestic partner; parent and child(ren); and family; and to dental insurance if they are enrolled in the health insurance plan. Part-time A employees who are appointed for at least four (4) complete consecutive calendar months are entitled to individual health insurance coverage, and are entitled to purchase Foundation health insurance coverage for spouses, domestic partners and dependents at Foundation group rates. Part-Time A employees and employees in concurrent Part-Time B status that add up to more than 19 hours/week for at least four (4) complete consecutive calendar months shall be eligible to enroll in the individual dental insurance, effective January 1, 2022. The parties to this Agreement recognize that specific terms of these health insurance plans are subject to change during the life of the Agreement. The Foundation shall provide the PSC with an opportunity to consult prior to making any such changes. All covered employees will contribute to the cost of their health insurance plan premiums as follows: 21% for the duration of this Agreement. Process for Obtaining Health Insurance Coverage Health insurance coverage is not automatically effective upon the employee’s eligibility date. In order to obtain health insurance coverage, employees who are eligible, or become eligible, for health insurance coverage must fill out and submit to the Foundation a formal application within sixty (60) days of the date on which they became eligible. Individuals who are newly-appointed (or re-appointed after a break in service) to Full-Time or Part-Time A employment status, will become eligible to participate in the Foundation’s health insurance plan(s) on the first day of the second complete calendar month of employment. A break in service shall be defined as a lapse in employment in excess of thirty (30) days, excluding approved leaves of absence. Once an employee establishes eligibility for health insurance, if the employee is reappointed for less than four (4) months, the Foundation shall continue to provide the employee with existing health insurance benefits. There is an annual open enrollment period during which an eligible employee may change health insurance plans. If no change is made during open enrollment, the most recent election remains in force. Health insurance coverage ends on the last day of the month following the final month of employment. To enroll a spouse, domestic partner or dependent(s) in his/her health plan, the eligible employee must present a Statement of Dependent’s Participation in Health Benefits Program Form accompanied by an original or certified document (marriage, domestic partner registration, birth, adoption or guardianship of a child) to the Foundation’s Office of Human Resources. An employee seeking to enroll a spouse, domestic partner or dependent(s) after the employee’s initial enrollment in a health insurance plan may do so only during the next open enrollment period, unless a Qualifying Event occurs. A Qualifying Event is defined as an event such as marriage, domestic partner registration, divorce, loss of coverage by a spouse or domestic partner, and the birth or adoption of a child. In order to participate under the Qualifying Event Election Period, the employee must submit a Statement of Dependent’s Participation in Health Benefits Program Form to the Foundation’s Office of Client Services within 30 days from the date of the Qualifying Event, or s/he forfeits his/her right to change coverage until the next scheduled Open Enrollment Period.
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