Page 6 - 2021 Team Member Benefit Guide - English

Benefits Eligibility

You are eligible to enroll for health and welfare benefits if you are classified as a full-
time employee who is regularly scheduled to work at least 30 hours per week.
If you are: Dependent Eligibility
; An existing employee making elections If you are eligible to elect coverage for
during 2021 Annual Enrollment (November yourself, you may also elect coverage for your
9-20, 2020): Coverage will be effective on eligible dependents.
January 1, 2021. Your eligible dependents include:
; New hire employee: Coverage will ; Your legal spouse
be effective on the first of the month ; Your children up to age 26 (25 years old
coincident with or following 60 days of full- or younger) – including
time employment (e.g., if you start working ; Natural children (born to you)
on January 15, your benefits eligibility ; Stepchildren
date is April 1). A notice of eligibility will ; Adopted children
be mailed to your home address. You ; Children whose legal guardianship
must enroll within 31 days of your benefit has been granted to you by the state
eligibility date. (See p.1 of this guide for ; Your unmarried grandchild under the
benefits eligibility dates.) age of 26 who is your dependent for
; A newly-eligible employee due to a federal income tax purposes
change in status from part-time to full- ; Your unmarried child age 26 and older
time: Coverage will be effective on the first who depends solely on you for support
of the month following or coincident with because of mental or physical disability
60 days of full-time employment based on where the disability arose before age 26
your status date change. (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 employees 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.
Click here or scan the QR code for the list of
acceptable documents needed for dependent
Yomara Villanueva, HR Generalist verification.
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