Health Plan Enrollment

New Therapists, Open Enrollment & Qualifying Events

Arch Wall with Curtain
Eligible Employees

Are requested to enroll or waive coverage within 14 days of the first day of employment.

Open enrollment occurs in September.

Frequently Asked Questions & Important Information

Why are medical rates based on age? 

You may be familiar with a composite (or blended) rate. A composite rate is based on the "average profile" of members rather than individuals. Composite rates don't work well for small businesses like Four Points or the employees of small businesses as it's hard to create a representative rate. In the next 1-2 enrollment cycles, we intend to move to a composite rate. 

How do composite and individual rates differ for dependents? 

With individual rates, each dependent has their own premium added to the cost of coverage. For example, if 2 dependents are added, they would each have a monthly premium of perhaps $300, adding $600 to the total per month. 

 

Under a composite rate, there is only one premium amount regardless of how many dependents are on the policy. If 3 dependents are added, they would have $300 total added to the monthly expense. This is one reason we're eager to move to a composite rate!

If I enroll in a medical plan, do I have to enroll in dental and vision?

No, you can enroll in only the plans you want. The benefits are independent of each other. The medical plan is the only benefit, though, with an employer contribution toward the premium. 

Do I have to enroll for my partner/spouse or dependents to enroll?

Yes, employees must enroll for family to be eligible to enroll.

When do policies become effective?

Effective dates are the 1st of the month following 30 days employment. For example, if May 15 is your start date, 30 days is approximately June 15. Your coverage becomes effective on July 1. 

If I decline coverage now, can I opt in later? 

You can elect coverage the next time open enrollment comes around, which occurs annually with coverage beginning in November. Qualifying events are exceptions: Marriage, birth of a child, loss of coverage, etc. In these cases, enrollment can occur outside of the usual  timeframe.

Waivers

Employees declining coverage for any plan must complete a waiver.

Medical

Vision

Dental

Waiver Requirement

Employee, Spouse/Partner, Dependents

Everyone eligible must waive if declining coverage

 

Employee Only

Employee Only

Only medical plans require spouses/partners & dependents to waive.

If the employee enrolls, family members added to the policy (if applicable) are listed on the same enrollment form. Family members who don't enroll waive coverage on the waiver section on the same enrollment form

If the employee does not enroll, the employee plus family members are listed on the waiver form. This is independent of the enrollment form. The link is titled, "Medical Waiver." 

Example

An employee is enrolling in medical coverage and will add her legal partner but will not enroll their child. She wants to enroll in the dental plan, but only for herself and is declining vision coverage.

Because she's enrolling in medical, she uses the medical enrollment form and lists her partner on the application. She uses the same form to list their child as waiving coverage.

She completes the dental enrollment form for herself and doesn't need to complete any waivers. She completes the vision waiver form and lists her own name. 

When will my insurance card arrive?

7-10 days after the effective date. You'll have access to a temporary card and your member ID in the meantime

I'm not sure what my first date of employment is. How do I find out?

Please contact Ashley Shaw and she'll let you know.

An employee, the employee's spouse, and their two children are eligible to enroll in health benefits. 

   >  The employee and one child want to enroll in medical coverage only.

​   >  The spouse and other child must be listed on the medical waiver​.

   >  All 4 family members (employee, spouse and 2 children) must be

       listed on the dental and vision waivers.