Initial (New Hire) Enrollment
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You are eligible to enroll in the Plan if you work for a Participating School Employer and you are a member of a group of Employees designated by your Participating Employer as eligible to participate.
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To enroll in the plan, you must return a completed
BCHP Enrollment/ Change Form to your Treasurer or Personnel Department within 31 calendar days after your hire date. Your employer requires newly hired employees to provide the completed forms
EVEN IF YOU DO NOT WANT TO PARTICIPATE. If you want to enroll in the Medical Plan, elect medical coverage and select the level of coverage; Employee, Employee +1 or Family.
Spouse's Enrollment
In order to be eligible for coverage under the BCHP Medical Plan, any Spouse of an eligible Employee who has coverage available through an employer sponsored group health plan
must join that plan on at least a SINGLE enrollment basis. If you enroll your spouse as a dependent, you must also complete the BCHP COB Questionnaire unless your spouse is already enrolled in his/her employer's medical plan. BCHP will coordinate benefits with your spouse's employer sponsored group health plan.
Annual Open Enrollment - November
Each year you have the opportunity to participate in the Medical Plan for the first time, change plan options,or add dependents without a qualifying event. You must return a completed
BCHP Enrollment/ Change Form to your Treasurer or Personnel Department to enroll or make a change. If you are adding a spouse, see Spouse's Enrollment.
Open Enrollment occurs in November of each year with coverage effective January 1 of the following year.
Communicate Family Status Changes, Qualifying Events and…
When family status changes occur, the last thing on your mind is to update your employer of these changes. However, failure to notify your employer may cause your medical claim payments to be delayed or denied. Also, your rights to enroll in the plan or continue coverage may expire.
Notify your Treasurer's office or personnel office on an enrollment/ change form of the following changes within 31 days of the
qualifying event:
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Marriage
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Adoption
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Qualified Medical Child Support Order
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Child turns 19.
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Child gets married.
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Address or phone number change.
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Special Provision: Newborns are covered at the moment of birth ONLY if you enroll your new baby in our Plan within the 60 days immediately following birth.
Your medical claim payments may be delayed or denied if you do not notify your treasurer's office or personnel office. District Contacts
are...
Continuation of Coverage - Consolidated Omnibus Budget Reconciliation Act
(COBRA) COBRA is a federal law which requires each group health plan to allow employees and eligible dependents to continue their group coverage for a stated period of time following a qualifying event that causes the loss of group health coverage. COBRA allows you or your eligible dependent to remain in BCHP for a specified number of months at 102% of the current premium cost. Qualifying events include reduced work hours, child reaching 19 and not a full time student, death or divorce of a covered employee, and termination of employment.
How do I elect COBRA?
You must notify you Treasurer's or personnel office on a BCHP Enrollment/ Change Form of the qualifying event. Your employer will notify
Allied who will send a COBRA notice describing your COBRA rights, the COBRA rates, and an
enrollment form. You must decide within 60 days from the date of the notice or the date coverage under the plan ends if you want to elect COBRA coverage.
COBRA EXAMPLES:
My daughter will turn 19 and is not a full student. Will she still be covered under my
plan?
NO. Her coverage ends at midnight on her 19th birthday. You MUST notify your employer within 60 days of her birthday in order to receive COBRA rights.
My divorce is final, what steps do I take regarding my ex-spouse's coverage?
You MUST notify your employer within 60 days of your divorce. Failing to do so will result in a forfeiture of their right to continue coverage through COBRA.
What is a Pre-Existing Condition?
It refers to any illness, injury or related condition for which you have received treatment during the 3 months immediately before you became covered under the plan.
Can Pre-Existing clause be waived?
YES, through the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This federal law allows all or part of your pre-existing waiting period to be waived. HIPAA prohibits discrimination based on health status and restricts pre-existing condition exclusions and limitations as long as there is proof of uninterrupted prior medical coverage.
How do I prove that I had previously uninterrupted credible coverage?
Acceptable ways to establish creditable coverage are:
1. Certificate of Credible Coverage: Your past employer or health plan will provide you with this document which states the effective date of prior coverage and the termination date for you and any covered dependents.
2. Coverage under Medicare or Medicaid
3. Individual health coverage
4. Coverage under state-risk pool
5. Coverage through Tri-Care Military Coverage (coverage for military personnel)
NOTE: The term uninterrupted coverage means that there must not be more than a 63 day break in coverage from one medical plan to another
