Page 15 - 2021 Mid Year Open Enrollment Guide

Benefits Eligibility How will my spouse know if his/her employer’s offer of coverage is
Qualifying coverage?
You are eligible to enroll for health and welfare benefits if you are classified as a full-time team- If your spouse’s employer offers health coverage, the employer is required by law to provide team
member who is regularly scheduled to work at least 30 hours or more per week. members with a notice indicating whether the employer’s coverage meets affordability standards.
Consult your spouse’s employer if you have questions about your spouse’s health plan.
If you are:
• An existing team member making elections during the 2021 Mid-Year Open Enrollment (April What if my spouse or child and I both work for the company?
19-30, 2021). Coverage will be effective on June 1, 2021. You may each enroll in the medical, dental, and vision plans individually as “Employee Only”, or
• New hire team member: Coverage will be effective on the first of the month coincident with you, or your spouse may enroll as “Employee + Spouse” (or “Employee + Family”). You cannot be
or following 60 days of full-time employment. A notice of eligibility will be mailed to your home enrolled as both an employee and a dependent. However, children of parents who both work for the
address. You must enroll within 31 days of your benefit eligibility date. company can be covered by only one parent’s plan. You cannot elect spouse life, or spouse AD&D
insurance if your spouse is also a regular, full time employee of the company.
• A newly-eligible team member due to a change in status from part-time to full-time: Coverage
will be effective on the first of the month following or coincident with 60 days of full-time
employment based on your status date change. MEDICAL PLAN SURCHARGES
Spousal Surcharge for Medical Coverage
Dependent Eligibility A team member’s spouse who has access to affordable health care that provides minimum value
If you are eligible to elect coverage for yourself, you may also elect coverage for your eligible (“Qualifying Coverage”, defined by the Affordable Care Act) through another employer may enroll in
dependents. Your eligible dependents include: a Builders FirstSource medical plan. A spousal surcharge of $100 per month will apply when you
• Your legal spouse certify that your spouse has access to his/her employer's Qualifying Coverage. A spouse who does
not have access to other Qualifying Coverage through an employer will not incur a surcharge when
• Your children up to age 26 (25 years old or younger) – including
enrolled in a BFS medical plan.
• Natural children (born to you)
• Stepchildren Tobacco Surcharge
• Adopted children Team members who enroll in a BFS medical plan and use nicotine products will pay an additional
$100 per month as a tobacco surcharge. The tobacco surcharge does not apply to a spouse.
• Children whose legal guardianship has been granted to you by the state See p. 13 for Tobacco Cessation program.
• Your unmarried grandchild under the age of 26 who is your dependent for federal income tax
purposes
• Your unmarried child age 26 and older who depends solely on you for support because of
mental or physical disability where the disability arose before age 26 (documentation is
required)

Dependent Verification
When you enroll dependents to your medical coverage for the first time, you will be contacted by
mail to provide documentation. Rehired team members may also need to re-verify any dependents
enrolled in the medical plan. If you disenroll a spouse in the medical plan and later re-enroll the
spouse, you will be required to provide a recent tax return or current proof of joint account. Please
ensure your address is correct in Dayforce and respond promptly.

Failure to provide this documentation within 31 days of the enrollment effective date, will result in
your dependents being removed from the medical plan retroactive to the benefit effective date.

What is an offer of qualifying coverage by an employer?
Your spouse is offered qualifying coverage if the medical plan offered is 1. “Affordable,” meaning
your spouse’s premium for the cost of the employee’s coverage does not exceed 9.78% of his/her
income and 2. Provides “minimum value,” meaning the plan pays at least 60% of the total allowed
costs provided under the plan.

12 • 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE • 13