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Saint Louis University

Q: My wife has been insured under a medical plan provided by her employer. She would like to stop working, but we are concerned about when she can come under my medical plan at the University as my dependent. Does she have to wait until the open enrollment period?

A: We have good news. It used to be, under just about any employer plan, that your wife would be required to wait until the annual open enrollment period to be added. The new Health Insurance Portability and Accountability Act (HIPAA) has helped your situation. When eligibility for group medical benefits provided through an employer is lost, the employer of his or her spouse must allow enrollment in the group plan of the spouse. Enrollment must be completed within 31 days from the date of the lost coverage. Dependents to be added to your plan also must meet the plan definition(s) of an eligible dependent. If your wife quits her job, be sure to enroll her in your University plan within the 31-day window. Upon termination of employment, your wife will need to obtain a HIPAA certificate of coverage from her old employer to present to the new plan. HIPAA certificates are specified under the law to serve as official notification to the new plan describing the lost coverage circumstances.

It is important to note that one cannot stop premiums to one employer plan in order to enroll in the plan of another. The loss of coverage must be due to loss of eligibility. Terminating employment causes a loss of eligibility that, in turn, causes a loss of coverage.

Q: If an employee works in a "temporary" position, does the time worked in this position count toward his or her service when hired into a full-time or part-time regular staff position for the University?

A: Service date reflects a summary of cumulative time in service in a full-time or part-time regular staff position. Employment in the "temporary" position will not count toward an employee's service.