Health Insurance FAQs
When is my insurance effective?
Health insurance is effective the first day of the month following your start date unless you started on the first work day of the month.
Start date is October 18th—
Health Insurance starts November 1st.
Start date is March 1st (the first work day in the month)—
Health Insurance starts March 1st.
Does my Health insurance deduction come out of every paycheck, even in the summer?
Your Health insurance deduction is taken over 20 pays from September through June. There are no deductions taken in July and August. To cover the summer months of July and August, an additional deduction is taken from January through June.
To calculate what that additional amount is, take your pay period amount on your Benefits Summary sheet and multiply it by 4. Take that amount and divide by 12.
BPA RASHP Value Single is $41.05 a pay period.
$41.05 x 4 = $164.20; then $164.20 /12 =$13.68.
$13.68 is the amount that would be taken in addition to the $41.05 pay period amount.
For the months of January through June, $54.73 would be your health insurance deduction.
What is an “HMO”?
HMO stands for Health Maintenance Organization, and with an HMO you must have a primary care physician that you see first for all medical issues.
If they are unable to treat you, you will be sent to a specialist within a network of health care providers (doctors, hospitals, etc.).
All of our RASHP 2 plans (RASHP 2 Value, RASHP 2 Select, RASHP 2 Extended) are HMOs.
How do deductibles work with the Signature High deductible Plan?
Employees pay 100% of their medical and prescription costs until the deductible is met—which is $1800 for a single plan and $3600 for a family plan starting January 1st of each year.
Once the deductible is met, the employee pays 10% of medical expenses and prescription co-pays of $5/$35/$70 until the maximum paid by the employee is met.
The maximum for single is $3600 and Family is $7200. After the max has been paid out, Excellus pays 100% of covered services.
When can I change Health insurance plans if I don’t like my current one?
Employees can change Health insurance during Open Enrollment, which lasts from November 1 through November 30th every year.
The plan you changed to will start the following January 1st.
Can I transfer to BOCES coverage if it is not Open Enrollment?
You may be able to transfer to BOCES coverage within 30 days of a “qualifying event”, which allows enrollment in insurance plans due to loss of coverage, marriage, birth of a child, etc.
I have a domestic partner. Can my partner be on my Health insurance?
You need to complete an affidavit with specific qualifications.
Once your eligibility is verified, your partner can be on your coverage. You will be responsible for the FICA/Medicare taxes on the difference in costs between insurance for yourself and insurance for you and your partner. You’ll receive a letter with that amount and a deduction will be taken every pay period.
What if I already have insurance through my spouse’s employer?
BOCES will pay you a stipend according to your contract in June and December once you have completed the Opt Out Form and provided proof of insurance. This amount will be prorated based on start date and part time.
Proof of insurance can be a medical card with your name on it or a letter from the employer stating that you and your dependents are covered.
We need the Opt Out Form and proof of insurance every calendar year.
I am under 26 years old and still on my parents’ insurance. What happens when I turn 26 and can no longer stay on their insurance?
When you are terminated from your parents’ policy, you will be eligible to transfer to BOCES’ insurance. This can happen because you have a “qualifying event”, which allows enrollment in insurance plans due to loss of coverage, marriage, birth of a child, etc.
You need to submit your paperwork (Enrollment/Change Form) to transfer within 30 days of your 26th birthday.
When do the rates change for insurance?
Our Health insurance rates change January 1st of every year, and they can increase, decrease or even stay the same.
What happens with my coverage if I leave Monroe One?
You may continue coverage after leaving Monroe One through a federal law called COBRA. However, you will pay full cost plus a 2% administrative fee to Excellus.