Individuals who work no less than 30 hours per week on a regular basis are eligible for coverage. An employer/employee relationship must exist and taxes must be deducted from each employee's salary.
Renewals
Your renewal information will be sent to your broker 90 days prior to your renewal date. Information, including all benefit changes, must be submitted at least one month prior to your renewal date. This is the only time you will be able to make changes to your benefits. Employees are only allowed to change their plan during open enrollment.
Enrollment
New Employees
New employees must complete both the Utah Small Employer Health Insurance Application and our Application Supplement form to enroll on the plan. If they do not wish to enroll, they must complete the SE Waiver Form. New employees include those who previously worked part time and did not meet the weekly hour requirement of 30 hours but now work full time and meet the requirement.
Special Enrollment Events
A special enrollment event is an opportunity to enroll in coverage outside of the annual open enrollment period. Special enrollment events only apply under these circumstances: loss of other coverage, new eligible dependents, or a change in legal guardianship. Enrollment must occur within 31 days of the circumstance.
Terminating Coverage
When an employee and/or enrolled dependent is being terminated from your health plan, you must submit an SE Change Form.
Instances where an employee and/or dependents may be removed from coverage include:
- Employee removes dependents from coverage;
- Termination of employment;
- Employee has a reduction in work hours below the required minimum; or
- Employee decides to voluntarily discontinue medical benefits.
Options for Continuing Coverage
Continuation of Coverage
Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) regulations apply to employers with 20 or more employees. Utah mini-COBRA regulations apply to employers with fewer than 20 employees. It is your responsibility as the employer to provide notice of COBRA or Utah mini-COBRA coverage to the employee, as well as information about their rights and responsibilities for continuation coverage. For more information about your responsibilities as an employer, you should contact your broker/agent or visit the Web site for the applicable continuation coverage program. For COBRA, visit the Department of Labor at www.dol.gov. For Utah mini-COBRA, visit the Utah Insurance Department at www.insurance.state.ut.us.
Applying for COBRA coverage
To enroll in cobra continuation coverage, qualified beneficiaries must complete a SelectHealth COBRA form. The plan under which the employee and any dependents were covered prior to the qualifying event must be marked. Employees are allowed to select another plan at open enrollment. Each qualified beneficiary has 60 days from the date of loss of coverage to elect COBRA coverage. A qualified beneficiary may elect COBRA coverage only if he or she has no other health insurance coverage, or his or her new health insurance coverage contains a pre-existing condition limitation that is in effect.
Applying for Utah mini-COBRA coverage
To enroll in Utah mini-COBRA continuation coverage, qualified beneficiaries must mark the “applying for Utah mini-COBRA” box in the employee termination/discontinue medical benefits section on the SE Change Form.