Health Benefits Summary for Temporary Employees

Key Features

Ancillary Coverage

Frequently Asked Questions

All full time temporary employees are eligible to enroll. Eligible dependents include spouses and unmarried children or stepchildren, under age 19. Full-time students at an accredited school and under the age of 23 are also eligible to participate.

Premiums will be taken through weekly payroll deduction. If you miss a payroll deduction as a result of absence or lack of work, no benefits will be extended for the following period. However, if a claim is incurred during a period of time when premiums were missed, the missed premium will be subtracted from the pended claim, maintaining a continuity of coverage. If a claim is not incurred during the missed premium timeframe, missed premium does not need to be made up. However, if you miss 5 consecutive weeks of premium, coverage will be terminated and you will not be eligible to re-enroll until the next open enrollment period unless you experience a qualifying event.

If the provider charges more than the scheduled benefit, the covered person must pay the provider the difference.

The insurance company pays the insured the difference between the amount billed and the scheduled benefit.

It means that the insurance company will pay a set amount each time the insured receives a covered service. The same amount is paid regardless of the fees charged by the provider.

Coverage for you and your eligible dependents begins on the first Monday following your first payroll deduction (unless dependent coverage is added at a later time). However, if any dependents are totally disabled on the usual effective date, their coverage will be deferred until they cease to be disabled.

Your coverage will end when you no longer qualify under the plan or when your premium payments are five weeks behind, whichever comes first. Coverage on dependents ends on either the date they no longer meet the definition of a dependent or, the date your coverage terminates, whichever comes first.

No. You must sign up for coverage in the first 30 days of your date of hire. Your coverage will begin the first Monday following your first payroll deduction. If you do not elect coverage in the first 30 days, you will not be able to enroll until the next open enrollment period unless you experience a qualifying event.

Yes. However, you will not be able to enroll until the next open enrollment unless you have another qualifying event.

The medical and Rx member kit will typically be mailed to you approximately 7-10 business days after your first payroll deduction. Please allow three weeks for this kit to arrive in your mailbox. The dental member kit is mailed separately.

Carolina Legal Associates

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