Voluntary Benefit Waiver
Purpose
The purpose of the voluntary benefit waiver option is to encourage eligible employees to waive unnecessary duplicate family coverage. Employees eligible for medical coverage who elect to waive medical coverage for a full year shall receive cash in lieu of coverage.
How to Waive Medical Coverage- Click here to print a Voluntary waiver form.
In order to receive payment, please complete the form and submit it to the Business Office by Friday, April 29, 2011. Requests for payment must include definitive proof of coverage. Please attach a copy of your medical ID card to this form. Please note: This waiver is irrevocable during the plan year, except upon a life changing event. Also, this waiver is for all medical coverage. You may not waive a level of coverage and be paid any difference in premium.
Payment
Payments will be made on June 30, 2012 for employees exercising the option to waive medical insurance for the 2011-2012 school year. Payments will run through payroll as a separate check and be reported as taxable income. Payments made for employees within the first five years of employment will be prorated accordingly.
· Single: $787
· Parent/Child: $1,145
· Husband/Wife: $1,941
· Family: $2,000
Re-Enrollment in Benefits
Employees and their dependents may re-enroll or elect health benefits after waiving benefits:
· During Open Enrollment.
· Upon the occurrence of a “life-changing event” during the course of the year.
The following are considered “life-changing events”:
o Change in legal marital status—marriage, death of spouse, divorce, legal separation or annulment.
o Change in the number of dependents—birth, adoption, placement for adoption or death of a dependent.
o Change in employment status—termination or commencement of employment by the employee, spouse or dependent, a strike or lockout, reduction or increase in hours, or unpaid leave of absence.
o Change in dependent’s status—a dependent satisfies or ceases to satisfy the requirements for coverage due to age, student status or similar circumstances.
o Residence or worksite—a change in the place of residence or work of the employee, spouse or dependent. |
