Q. I am getting married soon. Can I add my new spouse and/or stepchildren to my coverage, or do I have to wait until there is an open enrollment period?
A. You do have 60 days from the date of marriage to add your spouse and/or stepchildren to your health, dental, and vision coverage. After 60 days, "special enrollment" or "late enrollment" criteria may apply for health coverage, and late enrollees (after 31 days of event date) for dental or vision may be subject to waiting periods for coverage. You must contact the Benefits Coordinator to complete the appropriate documents and be able to provide a marriage certificate.
Q. I am expecting a baby soon. Can I add my newborn to my coverage?
A. You have 60 days from the date of birth or adoption placement (under age 18) to add a child to your medical, and 31 days for dental, and vision coverage. After 60 days, "special enrollment" or "late enrollment" criteria may apply for medical coverage, and late enrollees (after 31 days of event date) for dental or vision may be subject to waiting periods for coverage. You must contact the Benefits Coordinator to complete the appropriate documents and be able to provide proof of birth or adoption.
Q. My dependent child just turned age 19. Is he/she still covered?
A. Dependent children may be covered to age 23 under the Foundation's medical policy through CalPERS as long as they are unmarried, have never been married, and are economically dependent upon the employee. Dependent children may be covered to age 23 under the Foundation's dental policy through the Guardian if they are unmarried, have never been married, are economically dependent upon the employee and, between the age of 20 and 23, are enrolled as full-time students at an accredited school. Dependent children may be covered to age 23 under the Foundation's vision policy through the CPIC Life if they are unmarried, have never been married, are economically dependent upon the employee and, between the age of 19 and 23, are enrolled as full-time students at an accredited school. For all policies, there are exceptions for dependents who are mentally and/or physically disabled.
Q. Can my grandchild or niece/nephew be covered under my health plan?
A. If a grandchild is under the age of 18, unmarried, living in a parent-child relationship with a grandparent (in the absence of their natural parents), and economically dependent upon the employee, they may be covered under the employee's health plan. However, if the child related to employee is not a grandchild or is of no relation biologically, the employee must be the court appointed guardian of the child and legal proof of guardianship must be provided in order for the child to be covered by the employee's health plan. The dependent must be enrolled within 60 days from the date of custody. After 60 days, "special enrollment" or "late enrollment" criteria may apply for health coverage, and late enrollees (after 31 days of event date) for dental or vision will be subject to waiting periods for coverage. Please note, this rule does not apply to stepchildren who automatically become eligible dependents at the time their parent becomes an employee's spouse.
Q. Can my dependent parents be covered?
A. No. Parents are not eligible for coverage at this time under the CalPERS medical plan.
Q. I am resigning, or the term of my position expires at the end of the month. How long will my coverage be in effect?
A. Medical coverage is effective through the end of the month after the date of your resignation or termination of employment ( if your termination date is September 3, 1998, coverage is effective through October 31, 1998). Dental and Vision benefits will be continued through the last day of the month in which your employment terminates ( if your termination date is September 3, 1998, coverage is effective through September 30, 1998).
Q. Can I continue my health benefits if I resign or when my position ends?
A. Yes. COBRA Continuation Coverage provides you the option of continuing your medical, dental, and/or vision plans for up to 18 months (or longer in specific cases). You would become responsible for paying the entire premium amount to the carriers, plus a %.05 administrative fee for medical. The provisions of COBRA also apply to dependents who lose coverage due to legal separation, divorce, or age eligibility. Please contact the Benefits Coordinator for further information.
Q. When I am choosing a health carrier for medical coverage, are there restrictions for pre-existing conditions?
A. When an employee first becomes eligible to enroll in the group medical coverage through CalPERS, there are NO restrictions for enrollment with a pre-existing conditions with any carrier available to the organization within the service area. There are also NO restrictions for enrollment with a pre-existing condition with a health carrier during Open Enrollment.
