Eligibility

Learn more about the benefit eligibility requirements for yourself and your dependents.

Forsyth County Schools encourages the health and financial well-being of its employees by providing access to quality and affordable healthcare. The group insurance coverage described in this guidebook is available to all full-time employees. The coverage effective date will begin on the 1st day of the month following your first full calendar month of employment. All benefit elections must be made within 31 calendar days from your date of hire. The insurance plan year is from January 1st - December 31st. Once your enrollment window has closed, you may not make any changes to your elections unless you experience a Qualifying Life Event (QLE).

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
For Birth, Adoptions or Death, benefit changes and new rates become effective on date of event.
For Marriage, Divorce or Loss of Coverage, benefit changes and new rates become effective 1st of the following month.
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	Placement for adoption paperwork Legal documentation of adoption	No additional documentation required
Birth	Birth Certificate Verification of Birth Facts issued by hospital	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	Adding Spouse - Marriage Certificate Adding Children - Birth Certificate
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)	Adding Spouse - Marriage Certificate Adding Children - Birth Certificate

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:

Your legal spouse
A child through the age of 26. You can only make changes to the specific plans where dependents will be affected
A child is defined as your natural child, legally adopted child, stepchild, a grandchild who is a Dependent of the Participant for federal income tax purposes and resides full time with Participant, and any child for whom you are the court-appointed guardian
A child of any age who is medically certified as disabled and dependent on the parent for support and maintenance

Important Dependent Benefit Information

Medical, Vision, Dental	Coverage for dependent children ends the last day of the month the child turns age 26
Child Life Insurance	Coverage for dependent children ends the last day of the month the child turns age 26
Spouses are Eligible for:	Medical, dental, vision, life, accident, critical illness, and permanent life