Eugene School District 4J

Gain a Spouse or Domestic Partner by marriage or Eligibility –
The following changes to your Medical, Dental and Vision coverage is allowed if you gain a spouse or domestic partner.

• Employee may enroll newly eligible Spouse/Domestic Partner and children.
• Employee may waive medical coverage. Employee may decline dental and/or vision.¹
• Election of coverage may also be extended to previously eligible (but not yet enrolled) children.
• Employee may enroll or change plans if enrolling spouse/domestic partner and eligible dependent children.
• If electing a domestic partner, please fill out the Affidavit of Domestic Partnership.

The following changes to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected. Evidence of Insurability (EOI) for Optional Employee Life and/or Optional Spouse/Domestic Partner Life will be required to become insured for more than the Guarantee Issue(GI) amount.

Loss of Spouse or Domestic Partner by divorce, annulment, death or termination of Domestic Partnership
The following changes to your Medical, Dental and Vision coverage is allowed if you lose a spouse or domestic partner.

• Employee must cancel elections for ineligible children, ex-Spouse or ex-Domestic Partner.
  • Removing ex-Domestic Partner, please fill out Termination of Domestic Partnership.
• Employee may enroll eligible children who lost other employer sponsored group medical benefit plan.
• Election of coverage may also be extended to previously eligible (but not yet enrolled) children.
• Employee may enroll in plans. Employee may not cancel or change plans.

The following changes to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected. Evidence of Insurability (EOI) for Optional Employee Life will be required to become insured for more than the Guarantee Issue (GI) amount.
• Optional Spouse/Domestic Partner life insurance.

You have 31 days from the qualifying life event effective date to make any of these changes.  Please complete the appropriate Midyear Change Form and return to HR as soon as possible within the allowed time frame.

Covering your Dependent Children

“Child” means and includes the following:

• An eligible employee’s, spouse’s, or domestic partner’s biological son, daughter, stepson, or stepdaughter; adopted child, child placed for adoption, or legally placed child, who is 25 or younger on the first day of the month.  Grandchildren are only eligible when the eligible employee is the court-ordered legal guardian or adoptive parent of the grandchild.
• A person who is incapable of self-sustaining employment because of a developmental disability, mental illness, or physical disability.

Birth/Adoptions – (60 days to report this QSC)

The following changes can be made to your Medical, Dental and Vision enrollments:

• Employee may enroll newly eligible children.
• Employee may waive medical coverage.
• Employee may decline dental and/or vision.
  • Employee may opt out only if proof of other employer sponsored group medical benefit plan is provided to the Entity for input into the myOEBB system.
• Employee may remove children who become eligible under spouse’s plan.
• Coverage for a newborn child is effective on the date of birth.
  • The employee must add the newborn child to their coverage within 60 calendar days from the date of birth in order for the newborn child to be eligible for benefit coverage.
• Coverage for a newly adopted child is effective the date of the adoption decree or placement for adoption.
  • The employee must add the adopted child to their coverage within 60 calendar days from the date of the decree or placement in order for the newly adopted child to be eligible for coverage.
• Election of coverage may also be extended to previously eligible (but not yet enrolled) children.
• Employee may enroll or change plans if enrolling the eligible dependent child.

The following changes can be made to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected.
  • Evidence of Insurability for Optional Employee Life and/or Optional Spouse/Domestic Partner Life will be required to become insured for more than the Guarantee Issue (GI)
    amount.

Gain Eligible Child due to Marriage or Domestic Partner Eligibility

The following changes can be made to your Medical, Dental and Vision enrollments:

• Employee may enroll eligible child in existing plans.
• Election of coverage may also be extended to previously eligible (but not yet enrolled) children.
• Employee may not cancel plans.

The following changes can be made to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel even when eligibility is not affected. Evidence of Insurability (EOI) for Optional Employee Life and/or Optional Spouse/Domestic Partner Life will be required to become insured for more than the Guarantee Issue (GI) amount.

Child reaches age 26 or gains other group coverage

The following changes in your Medical, Dental and Vision enrollments are applicable:

• Employee must remove ineligible child from existing plans.
• Employee may not cancel or change plans.

The following changes in your Optional Life Insurance are applicable:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected.
• Employee must cancel optional child life if employee has no remaining dependents.

To add or remove a child from your plans please fill out a Midyear Change Form and return it to HR as soon as possible within the allowed time frame.

Spouse, Domestic Partner or Dependent Child gains other group coverage – you have 31 days to report this QSC

The following changes to your Medical, Dental and Vision enrollment are allowed:

• Provided that eligibility was gained under Spouse/Domestic partner’s employer sponsored group medical benefit plan, employee
  may opt out.
• Employee may waive medical coverage and/or decline dental and/or vision.
• Employee may remove individuals who gain other group coverage.
• Employee may remove the eligible dependent child that gained other employer sponsored group medical benefit plan.

The following changes to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected.
  • Evidence of Insurability (EOI) for Optional Employee Life and/or Optional Spouse/Domestic Partner Life will be required to become insured for more than the Guarantee Issue (GI) amount.

Spouse/Domestic Partner or Child involuntarily loses other group coverage – you have 60 days to report this QSC

The following changes to your Medical, Dental and Vision enrollment are allowed:

• Employee may enroll for employee, Spouse/Domestic Partner or eligible children who lose coverage under Spouse/Domestic Partner’s
  medical, dental, or vision plans.
• Election of coverage may also be extended to previously eligible (but not yet enrolled) children.
• The OEBB eligible member may enroll in or switch to any OEBB plans when there is a loss of eligibility under the
  Spouse’s or Domestic Partner’s group coverage.

The following changes to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected. Evidence of Insurability (EOI) for Optional Employee Life and/or Optional Spouse/Domestic Partner Life will be required to become insured for more than the Guarantee Issue (GI) amount.

The following changes to your Optional Life Insurance:

• Employee may enroll, increase, decrease, or cancel coverage even when eligibility is not affected.
  • Evidence of Insurability (EOI) for Optional Employee Life and/or Optional Spouse/Domestic Partner Life will be required to become insured for more than the Guarantee Issue (GI) amount.

If you become seriously ill or disabled and unable to work in your normal capacity, benefits are very important.  The benefits during your leave are based on many factors.  The best thing for you to do is to contact the HR office immediately.  You can find our contact information here.

Some links that may be helpful during this time are:

• Family and Medical Leave Act
• Oregon Family Leave Act
• Bargaining Agreements
• 4J Leaves of Absence

Is your employment status changing?  The following changes may have an effect on your benefit eligibility.

Are you moving from a non benefit eligible position into a benefit eligible one?
First of all, CONGRATULATIONS!  Click here to get some additional information about your new benefits!

Are you reducing hours to no longer be benefit eligible?
If your hours are being reduced to less that .50 FTE and you will no longer be eligible for benefits there are a few things that are important to know.  If you are currently enrolled in benefits, your benefits will remain in effect until the last day of the month in which your eligibility changes, unless otherwise stated as part of your employment contract.  The termination of coverage will automatically be processed.  If you are eligible for COBRA coverage, you will receive the enrollment  paperwork at your home address.  Please ensure that we have the correct address on file.

Are you retiring?
There are many exciting things to consider as you consider or plan for retirement.  You have many resources available to you through PERS and the District.  You can contact your appropriate Benefit Coordinator for additional information.  You can get their contact information here.

Are you leaving 4J?
There are a few things that are important to know as you transition from 4J.  If you are currently enrolled in benefits, your benefits will remain in effect until the last day of the month in which your employment terminates unless otherwise stated as part of your employment contract.  The termination of coverage will automatically be processed.  If you are eligible for COBRA coverage, you will receive the enrollment  paperwork at your home address.  Please ensure that we have the correct address on file.