CENTRAL CONNECTICUT STATE UNIVERSITY
GRAPHICS FREE PAGESPersonnel Department
HEALTH INSURANCE
MEDICAL INSURANCE
As an employee of the University you have the option to choose from several different health insurance plans offered by the State of Connecticut. Among the choices are Point of Service plans, Point of Enrollment plans and a Health Maintenance Organization.
Detailed information on plan provisions, insurance providers and rates are available in the Personnel Office.
POINT OF SERVICE PLAN (P.O.S.)
Under a Point of Service plan, members have a choice of obtaining health care in-network or out-of-network. Services obtained from network providers are covered in accordance with the Point of Service schedule of benefits; varying co-payments are required for different types of care. When using non-network providers there are deductibles to be satisfied and higher out-of-pocket expenses for services. Please refer to the provider provisions for specific information.
POINT OF ENROLLMENT PLAN (P.O.E.)
Under a Point of Enrollment plan, health care services are available from a network of physicians and other health care providers. Health care services are covered in accordance with a published benefits schedule.
P.O.E members who obtain health care services from providers outside the network pay the full cost for the services, unless they are necessitated by an emergency. Please refer to the provider plan for specific information.
HEALTH MAINTENANCE ORGANIZATION (HMO)
Under the Health Maintenance Organization, all covered services must be obtained from network providers at a medical center or through an affiliated group practice.
OPEN ENROLLMENT
An open enrollment period is offered annually. At that time, you may change from one health insurance plan to another.
OUT OF STATE RESIDENTS
If you reside outside of Connecticut, coverage is available through the Anthem BlueCross State Preferred Point of Service Plan.
PREMIUM CONVERSION (TAX BENEFIT)
A tax benefit is available to you by paying your health insurance premium by payroll deduction. The benefit, called premium conversion, provides that the employee share of health insurance premiums is taken from your paycheck on a pre-tax basis. This provides a legal way of avoiding income taxes on health insurance premiums by subtracting the cost from gross pay. It does not lower the figure used to determine retirement, disability insurance, or life insurance benefits.
DENTAL INSURANCE
You may choose to enroll in either an Indemnity Dental Plan or a Managed Care Dental Plan. Information on service providers and enrollment forms are available in the Personnel Office.
COBRA (CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT)
A TEMPORARY EXTENSION OF HEALTH COVERAGE
Under federal law, the State of Connecticut is required to offer covered employees and covered family members the opportunity to elect temporary continuation of health coverage at group rates, in certain instances in which coverage would otherwise end.
If continuation coverage is elected, the state is required to give coverage that is identical to the coverage provided preceding the qualifying event. The law requires that you or your qualified dependents be given the opportunity to maintain continuation coverage for 36 months unless your group coverage is lost because of a termination of employment or reduction in hours. In those two cases, the required continuation coverage period is 18 months. The law also allows continuation coverage to be discontinued for any of the following reasons:
- The State of Connecticut no longer provides group health coverage to any employees;
- The premium is not paid;
- You or your qualified dependent is covered under another group health plan;or
- A qualified individual covered by COBRA due to a disability is determined by Social Security to be no longer disabled; or
- You notify the COBRA Administrator that you wish to cancel coverage.
FOR THE EMPLOYEE
You have the right to elect continuation of coverage if group health coverage is lost because of a reduction in hours of employment or termination of employment for reasons other than gross misconduct.
FOR THE EMPLOYEE'S SPOUSE
Your spouse has the right to choose continuation coverage if group health coverage is lost for any of the following reasons:
1. In the event of your death.
2. Termination of your employment (for reasons other than gross misconduct) or reduction in hours.
3. Divorce or legal separation.
FOR A DEPENDENT CHILD
Your dependent child has the right to continuation coverage if group health insurance is lost for any of the following reasons:
- In the event of your death.
- Termination of your employment (for reasons other than gross misconduct) or reduction in hours.
- Divorce or legal separation.
- The dependent ceases to be a "dependent child."
Federal law requires that dependent children who turn 19 and are no longer covered by a group insurance plan (medical or dental) be offered COBRA benefits.
EMPLOYEE RESPONSIBILITY
You or a family member has the responsibility to notify the Personnel Office of a divorce, legal separation, or of a child losing dependent status. This must be done within 30 days of the date of the event or the date on which coverage would be lost because of the event. Once the Personnel Office is notified, the necessary paperwork for COBRA will be forwarded. You or your qualified dependent will have 60 days from the date coverage will be lost, or the date notified by the University, whichever is later, to elect COBRA. Billing is done directly by the COBRA Unit at Anthem BlueCross BlueShield on a monthly basis. If continuation coverage is not elected within the specified period, the right to elect continuation coverage will end.
You do not have to show that you are insurable to choose continuation coverage, however, you must pay the entire premium plus a 2% administration fee. The law states that at the end of the continuation coverage period, you must be allowed to enroll in an individual conversion health plan provided under the state program or as provided by state statute.