2020-2021 Benefits Guide rev 6.22.2021

• Death • Child reaching age 26

• Child’s loss of eligibility on another plan • Spouse’s gain or loss of other coverage A child is terminated from medical and dental on the last day of the month he/she attains age 26. When a child gains or loses Children’s Health Insurance Program also known as CHIP, employees have 60 days to provide documentation of the gain or loss of coverage to make a corresponding change to their coverage (adding or dropping). If notification isn’t made to the HR Administrator within 30 days of the event, then employees must wait until the next Open Enrollment period. However, you must notify the HR Administrator to drop coverage for dependents who no longer meet eligibility requirements. Coverage effective dates for Qualifying Life Events Qualifying Event – Other than Birth/Adoption of Child If you enroll within 30 days of the qualifying life event, coverage for you and any dependents you enroll will be effective on the first day of the month following the date you submit the enrollment form. Qualifying Event – Birth/Placement/Adoption of Child If you enroll within 30 days of the date of birth, coverage will be effective on the date of birth; even if you have family coverage, you must complete an enrollment form. Premium is due for any period of dependent coverage if the dependent is subsequently enrolled, unless, specifically not allowed by applicable law. Additional premium may not be required when dependent coverage is already in force. If you enroll within 30 days of the court-ordered adoption, placement for adoption, guardianship or conservatorship of a child, coverage will be effective on the date of the adoption, placement for adoption, guardianship or conservatorship; even if you have family coverage, you must complete a Benefits Enrollment Form. Enrollment Tips • Have Social Security numbers, birth dates and required documentation to enroll your eligible dependents. • Choose your options carefully. Once you make an election as a new hire, during open enrollment or within the 30-day qualifying event window, you cannot cancel or change to another plan (i.e., switch your health insurance plan). Group insurance plan premiums are deducted from your paycheck before calculating payroll taxes. Because of these pretax tax savings, the IRS determines when you may make changes—either annually during open enrollment or during the plan year if you experience a qualifying life event. • If you are a new hire, complete your enrollment forms via NeoGov Onboard. • Enroll online in ADP during open enrollment or within 30 days from your date of hire if you are a new employee. If you miss either of these enrollment deadlines, then you must wait until the next open enrollment period unless you experience another qualifying event during the year that allows you to make a change. • If you are hired during open enrollment and your benefits become effective prior to the new plan year, you will have to make new hire elections for the current year first, and then make open enrollment elections/changes for the next plan year. • Medical benefit plans run from October 1st through September 30th.

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