Eligibility
Learn more about the benefit eligibility requirements for yourself and your dependents.
Eligibility
Douglas County offers medical, dental and vision insurance to regular (non-temporary) employees who work more than 20 hours per week. The insurance is effective on the 1st day of the month following thirty (30) days of regular employment. Insurance benefits may be selected in any combination or tier of coverage. Premiums are deducted pretax each pay period starting on the month insurance is effective. The insurance plans may be waived if you already have other insurance. Please see the “Employer Mandate” section under the Patient Protection and Affordable Care Act (PPACA) for the penalties for not having insurance.
Mid-year Benefit Changes
You may add or cancel coverage during the plan year if you experience a Qualifying Life Event. You must notify the benefits department within 30 days of the change.
What is a Qualified Life Event (QLE)?
Generally, benefit changes are limited to open enrollment.
If you experience a Qualifying Life Event (for instance: getting married or having a baby), please contact the Benefits Coordinator; proof of the Qualifying Life Event must be submitted to the Benefits Coordinator within 31 calendar days in order to change current benefit election.
Benefit Elections must be consistent with the event
You can only make changes to the specific plans where dependents will be affected
Benefits and new rates become effective the date of the event for birth, adoptions, marriage, divorce, and death; or the day after benefits end, when the event is loss of coverage
The event date must be consistent with the information in the Supporting Documentation
Qualifying Event | Supporting Documentation | Dependent Documentation |
Marriage | Marriage Certificate | Birth Certificates are required if adding spouse's children |
Death | Death Certificate | No additional documentation required |
Divorce | Certified copy of Divorce Decree | Birth Certificates are required if adding children not currently enrolled in benefits |
Adoption |
| No additional documentation required |
Birth |
| No additional documentation required |
Loss or Gain of Coverage | Proof of enrollment or termination of benefit coverage from spouse's employer. Proof must contain effective or termination dates of coverage, type of coverage (medical, dental, vision, etc.) and the names of dependents effected |
|
Gain of Medicare or Medicaid | Proof of enrollment of benefit coverage. Proof must contain effective or termination dates of coverage, type of coverage (medical, dental, vision, etc.), and the names of the dependents effected (has 60-day window) |
|
Dependent Eligibility
If you apply for coverage for yourself, you may also elect coverage for any of your eligible dependents. Eligible Dependents include one or more of the following:
Legally married spouse
Biological, adopted or stepchildren up to age 26
Children over age 26 who are disabled and depend on you for support
Children named in a qualified medical child support order (QMCSO)
For additional coverage information, please refer to the benefit booklets for each benefit.