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Eligibility
You are eligible for Trust-sponsored benefits if you are an active full or part-time
permanent employee, including established term employees, and a member of:
- OCSEA/AFSCME - Units 3-9, 13, 14, 45, 50, 55
- District 1199/SEIU - Units 11, 12
- OSTA - 1, 15
- FOP/OLC - Units 2, 46, 48
- SCOPE/OEA - Unit 10
- CWA - Unit 40.
Trust benefits include dental, vision, basic life and supplemental life insurance,
Working Solutions, as well as the legal service plan.
Established term employees should talk with their Payroll/Personnel officers
for eligibility and enrollment information. In general, unless excluded by agency-specific agreement, established term employees will be eligible for all Trust benefits after meeting the waiting period. However, the legal service plan is not available to established term employees.
For dental, vision, and basic life insurance coverage, you must have one year
of continuous State service; and once elected, your coverage will be effective
the first of the month following your enrollment. You must enroll in dental and vision coverage within 31 days of your anniversary date. Your basic life coverage does not require enrollment but you must be actively at work for coverage to begin.
Supplemental life insurance, the legal service plan and Working Solutions are available to
you upon hire. (You have 90 days from your date of hire to purchase supplemental
life insurance and/or the legal service plan, and will have the opportunity to enroll in or change your coverage under these plans
at each Trust-sponsored open enrollment.)
While the Trust mails enrollment materials to your homes, we strongly encourage you to review the information online and make your selection. You may use the forms and books to enroll in coverage if you do not receive or misplace your enrollment packet.
Dependents
If you, the employee (member), are eligible for Trust benefits, you may cover
the following dependents:
| 1. |
your current legal spouse
and your unmarried children until the end of the month in which they reach
age 19. "Children" includes |
- children born to you
- stepchildren residing with you 51% of the time of more*
- foster children*
- legally adopted children*
- dependent children, upon being placed in the home for adoption* and children for whom you have been
appointed legal guardian.*
| 2. |
your unmarried dependent
children from age 19 until the end of the month in which they reach age
23 if they are primarily dependent on you for maintenance and support and
are attending an accredited school.* |
| |
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| 3. |
unmarried children of
any age who are primarily dependent on you and incapable of self support due
to mental retardation or a physical handicap* will be eligible as long as
you maintain your eligibility. |
*Documentation may be required with an affidavit when you first enroll or when the child is first eligible, or annually for dependents over 19. The Trust dental
and vision plans have the same affidavit/documentation requirements as the medical plan. Please talk with your Payroll/Personnel officer for more information and
an affidavit form, if necessary.
Voluntary options may have more liberal eligibility definitions. Please see the plan details for more information.
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When dependents' dental and/or vision coverage ends, you may extend it through COBRA.
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Limits & Exclusions
- No person is considered a dependent while in the armed forces.
- A child who is eligible as an employee of the State is not eligible as the dependent of either parent who also may be a State employee.
- A divorced spouse is not eligible as a dependent.
- When you and your spouse are both State employees, one may carry family coverage and the other single coverage, provided that the spouse is not listed as a dependent under family coverage.
See your Payroll/Personnel officer for more information.
| Eligibility/Enrollment
Chart |
|
|
Who's Eligible
|
When
Eligible |
To
Enroll |
Premium Paid By
|
|
|
Member
|
|
Family
|
|
|
|
| Dental
|
|
|
|
First
of the month following one year continuous State service |
Complete
an enrollment form within 31 days of hire anniv. date
|
Trust
|
| Vision
|
|
|
| Basic
Life |
|
|
|
First
of the month following one year continuous State service |
Automatic |
Trust
|
| Supplemental
Life |
|
|
|
On
hire date |
Complete
Prudential supplemental life enrollment form within 90 days of hire or at open enrollment |
Member
|
| Working
Solutions |
|
|
|
On
hire date |
Automatic
|
Trust
|
| Legal Service Plan |
|
|
|
On
hire date |
Complete
Hyatt enrollment form within 90 days of hire or at open enrollment |
Member
|
This chart applies to full-
and part-time employees. Established term employees should discuss eligibility/enrollment
information with their Payroll/Personnel officers.
Changes During the Year
You may change your coverage level (single or family) during the year if you have a family status or employment-related
coverage change. You must complete and return an Enrollment and Change form and, if necessary, an Affidavit of Dependent Status, within
31 days of the change or you will have to wait until the next open enrollment to adjust your coverage level. If you have enrolled in the Hyatt legal service plan, you may change from single to family or family to single coverage level following a family status change, but you must
complete Hyatt's form separately (within 31 days of the change) to make the change effective, and you must remain in the plan until the end of the plan year.
Review the chart below to see if you may change your coverage level.
| Change
|
|
Type of Coverage Change Allowed |
|
Date Change Effective |
| Marriage
|
|
Add dependent spouse (and spouse's children) |
|
First of the month following your marriage* |
| Birth or adoption |
|
Add dependent child |
|
Date of birth or placement in home* |
| Legal guardianship |
|
Add dependent child |
|
Date of receipt of final papers* |
Divorce
(you provided coverage) |
|
Drop spouse |
|
Last day of the month in which divorce occurred |
Death of dependent
(you provided coverage) |
|
Drop dependent |
|
Last day of the month in which death occurred |
Loss of coverage
through spouse's employer if spouse laid off, terminated, dies or divorces you |
|
Enroll in coverage
Add dependent |
|
Date varies by type of change; see your Payroll/Personnel officer |
Return to work
through arbitration order or grievance settlement or administrative order |
|
Re-enroll |
|
Date varies by settlement agreement; see your settlement notice |
* For supplemental life insurance coverage, dependents must be at least 14 days old.
Plan Changes for Dental and Vision Coverage
If you have at least one year of continuous State service, you may enroll in any of the Trust's dental or vision plans. However, once you have enrolled in
a plan, you may not change to another plan, even if you move within Ohio, until the next Trust-sponsored open enrollment.
Also, if your dental or vision provider leaves the network, you will need to visit another participating network provider to continue receiving
the higher level of benefits.
Please make sure you request a directory to determine which providers belong to the networks of the dental and vision plans you are
considering.
If You Lose Your Dental or Vision Coverage
If your and/or your dependents' dental or vision coverage ends, you may extend it temporarily under COBRA. COBRA, the Consolidated
Omnibus Budget Reconciliation Act, is a federal law requiring employers to extend group rates to employees and/or their dependents who would otherwise lose their
coverage. COBRA is available for the Trust's dental and vision plans.
You are responsible for the full cost of coverage and an administrative fee (up to 2% of the coverage's cost). If you fail to make a COBRA premium payment,
you will lose coverage under this plan permanently.
Your Payroll/Personnel officer will provide you with COBRA information when you lose coverage.
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