Before-tax Benefits Defined

Employees do not pay federal, state, city, or Medicare taxes on their contributions to purchase before-tax benefits.  An employee's contributions for these benefits come out of his/her paycheck before taxes are calculated.  That is why these contributions are called before-tax contributions.  These before-tax contributions reduce taxable income.  Because taxes are figured on a lower amount of income, employees pay less tax.

Before-tax contributions offer employees valuable tax benefits.  Keep in mind that:

• before-tax contributions are tax-exempt, not taxed-deferred,
• taxes will not be due later, and
• before-tax contributions do not affect other pay-related benefits.

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Default Benefits Elections

If an employee is enrolling for the first time, he/she will be enrolled in the following:

• Medical - HMO Employee Only
• Dental - Basic Plan Employee Only
• Employee Life Insurance - One times the employee's annual base pay.

An employee has 45 days from his/her initial eligibility date to make his/her enrollment decisions using Employee Self Service (ESS). Employees may waive participation in all plans other than Employee Life Insurance (employees must select a minimum of $5,000 coverage).

During the plan's annual enrollment period, employees' current year benefits will continue into the next calendar year, with the exception of the flexible spending accounts.  Employees must re-enroll in the flexible spending accounts each calendar year.

Qualified Status Changes (QSC)

Family Status Change

When a life-changing event occurs, you can make a mid-year change to your current benefit elections without waiting for the annual election period (typically in the fall of each year for the following calendar year).

In most cases, the effective date of the change of the "qualified" family status change is the "event date."  However, in some situations (divorce, legal separation, change to employment), the effective date of the change is the first of the month following the "event date."

• The benefit change must be consistent with the type of qualified status change.  The type of benefit change permitted depends on the type of coverage involved.
• The employee must notify the Human Resources Department of a qualified status change within 31 days of the qualified status change. 
• If the 31-day deadline is missed, the employee must wait until the next enrollment period or the next status change to request the change.
• Coverage category changes and other changes become effective on the date of the qualified status change.

Add a Dependent

The IRS permits a change to your annual election within 31 days of the following qualified family status events:

• Marriage
• Domestic Partner
• Addition or Adoption of Dependent Child

Documentation must be submitted to add a dependent.  The Human Resources website has additional information on dependent verification.

For involuntary loss of coverage, you must submit a HIPAA Certificate of Coverage from the previous employer along with the other required documentation.

If due to a significant increase in the cost of benefits, you must provide confirmation from the employer providing coverage along with the other required documentation.

Remove a Dependent

The IRS permits a change to your annual election within 31 days of the following qualified family status events.  You must provide the documentation indicated.

Plan Enrollment Change Due to Relocation

Employees may submit a plan enrollment change from the HMO to POS or First 1000 Plan due to the employee's relocation or the relocation of his/her spouse (available only if enrolled in the HMO and the employee's new residence is outside the HMO network).  The employee must submit proof of new residence.

Types of Changes

Below are examples of the types of changes that can be made to each benefit plan:

NOTE: When an employee has a qualifying status change, it is also a good time to review beneficiary(ies) named to receive benefits in the event of death.  Changes in family situations do not automatically alter or revoke previous designations.  Prior designations remain valid until the employee completes a new designation form.  A will does not supersede a beneficiary designation.  Employees may change name or change beneficiaries at any time online via Employee Self Service (ESS).

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When Coverage Ends

The benefit elections that an employee makes when initially eligible or during annual enrollment will remain in effect for the calendar year of the election as long as the employee remains an eligible employee of the university.  If employment is terminated either by the employee or the university, the employee's coverage will end.

The table below shows when an employee's coverage under each benefit plan ends if his/her employment were terminated.  It also shows what options the employee has to continue that coverage after termination.

* Dependent/Family Life Insurance can only be ported if employee coverage is ported.

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