Article VI.10 Group Insurance Benefits: Procedures

Policy

⇓ Procedures ⇓

Article IV.10 Group Insurance Benefits Procedures (effective July 1, 2021)

Group Insurance Eligibility and Effective Date

All College group insurance plans are available to full-time employees on the first day of the month following the completion of 45 calendar days of employment in a full-time position. Group medical benefits are available to part-time employees who are determined to have met the 30 work hours per week requirements under PPACA detailed further below. College and employee cost-sharing is approved by the Board of Trustees; information is available on the website and on the Human Resources department portal page.

Medical Coverage for Part-Time Employees who Average 30 hours per Week: Patient Protection and Affordable Care Act (PPACA)

In accordance with the Patient Protection and Affordable Care Act (PPACA), group medical insurance is available to qualifying part-time employees.

Regular part-time employees are hired to work up to 29 hours per week, and while the College does not expect they will exceed 29 hours per week, their actual hours worked are tracked for purposes of PPACA. As such, part-time  employees who average 30 or more hours per week during the College's standard Measurement Period, and when choosing to enroll during the College's Administrative Period, group coverage will continue through the College's Stability Period as long as College employment and any applicable employee-paid premiums are maintained. All part-time employees are considered variable part-time when applying PPACA administrative procedures. The intent of these procedures is to fully comply with the Patient Protection and Affordable Care Act (PPACA) and any subsequent revisions, clarifications, or guidance issued.

Definitions

Measurement Period

A Measurement Period is a period of time during which the SCC Human Resources department will "look back" to see how many hours of service per week part-time variable hour employees were credited on average. This average is used to determine the eligibility or continued eligibility for medical insurance for most employees.

Administrative Period

An Administrative Period is a period of time between the Measurement Period and the Stability period, during which the SCC Human Resources department will determine which employees are eligible for medical insurance and will notify and offer enrollment.

Stability Period

A Stability Period is the medical insurance coverage period for an eligible part-time variable-hour employee.

Measurement, Administrative, and Stability Periods

For part-time employees (referred to as variable hour employees under PPACA), the College will look back at the employee's hours worked during a standard Measurement period to determine the average weekly hours worked. In the event that the employee averages 30 or more weekly hours worked, medical coverage will be offered to the employee during an Administrative Period. If the eligible employee enrolls in the medical plan, coverage will continue for the entire Stability Period as long as College employment and any applicable employee-paid premiums are maintained.

Adjunct Faculty

For part-time faculty (Adjunct): A standard calculation will be applied whereby every workload credit hour equals 2.58 hours worked per week. That means a 3-credit-hour course is equivalent to 7.74 hours of work per week. This calculation is based on class time, office hour, and prep time considerations.

Adjunct Faculty Exceptions

There are certain areas where the standard calculation does not accurately reflect hours worked due to unique circumstances, such as music lessons, certain labs, and some non-teaching administrative additional assignments. In these instances, hours are calculated accordingly.

Continuing Education Instructors

Hours worked by Continuing Education Instructors is calculated based on classroom time.  

Insurance Determination and Insurance Coverage Schedule for Qualifying Part-Time Employees

Ongoing Part-time Employees

Measurement Period (12 months): October 15 - October 14

Administrative Period (2 1/2 months): October 15 - December 31

Stability Period (12 months): January 1 - December 31

New Part-time Employees

Partial Administrative Period (up to 13 days): Number of days in a pay period for someone who starts after the 1st day of a pay period

Initial Measurement Period (11 months): Begins the 1st day of the 1st full pay period beginning on or after hire date

Administrative Period (45 days + up to 30 more days): 45 day administrative period, coverage will begin the 1st day of the 1st calendar month beginning on or after administrative period

Stability Period (12 months): Same length as stability period for ongoing employees

Special Unpaid Leave Rule

Unpaid time off taken under the Family and Medical Leave Act (FMLA), or unpaid military leave under the Uniformed Services Employment and Reemployment Rights Act (USERRA), or unpaid time spent on jury duty will not be counted against the employee in calculating average weekly hours during the measurement period.

Employment Break Period Rule

Regulations are provided for educational institutions to exclude employment break periods of 4 weeks to 26 weeks. For this purpose, an employment break period is a period of at least four consecutive weeks (disregarding Special Unpaid Leave), measured in weeks, during which an employee is not credited with hours of service. SCC will exclude (or credit) up to 501 hours of services during employment break period in a calendar year (no limit applies for Special Unpaid Leave). When a break in service is between 4 weeks and 26 weeks and the break is longer than the most recent period of employment (disregarding Special Unpaid Leave), the employee will be treated as a new hire, for purposes of this policy, upon returning to work.

Insurance Conversion Privileges (COBRA)

According to the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, in the event of termination of employment or loss of eligibility to remain covered under group insurance programs, employees and eligible dependents may have the right to continued coverage, at their own expense for a limited period of time.

Medical/Dental Insurance

If enrolled in the College’s medical and/or dental insurance, each qualified recipient has the right to continue medical and/or dental coverage for up to 18 months, or in certain circumstances, up to 29 months or 36 months. The employee/eligible dependent will pay the full premium and may be charged any applicable administration fee as allowed by law. 

Dependent Care Flexible Spending Account

If participating in a dependent care flexible spending account, the employee may continue to request reimbursement for qualifying dependent care expenses for the remainder of the plan year to be drawn from the balance remaining in the dependent care account at the time of termination. No further contributions may be made. All claims must be submitted within 90 days of the end of the plan year. 

Medical Flexible Spending Account

If participating in a medical flexible spending account at the time of termination, the employee may continue individual contributions and claims to the medical flexible spending account through COBRA provisions until the end of the plan year, if there is a positive balance in the account at the time of termination. The employee may be charged any applicable administration fee as allowed by law. 

Beneficiaries

Upon termination or upon notification of a qualifying event, information regarding continuation of coverage is sent or delivered to qualified beneficiaries. 

Basic Life, Voluntary Supplemental Life Insurance, and Long-Term Disability Insurance

Conversion of Basic Life, Voluntary Supplemental Life Insurance, and Long Term Disability Insurance will be permissible as allowed by the provisions of each plan. 

PEERS and PSRS Retirees

In accordance with Missouri statutes, the employee, if participating in the Public Education Employees Retirement System (PEERS) or Public School Retirement System (PSRS), may elect upon retirement continued coverage in the College’s group medical insurance plan. 

The retiree must elect coverage within one year from date last employed by the College or a Missouri school district in order to qualify for retiree insurance coverage. Retiree’s dependents may also be enrolled according to the terms of the plan pertaining to eligible dependents. The retiree will pay the full amount of the premium for the retiree and any covered dependents. No administration fee is charged. 

Content Owner: Human Resources
Revised: 07/2005, 11/2012, 02/2015, 08/2017, 11/2017, 11/2020 (effective July 1, 2021)



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