Employee Benefits & Services

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Group Health Insurance for Dependents

Citation Reference
Official Title	Policy on Group Health Insurance for Dependents
Abbreviated Title	Group Health Insurance for Dependents
Volume	Human Resources
Responsible Office	Human Resources
Originally issued	October 2010
Revised

Policy Statement

The University System of Georgia (USG) recognizes the importance of managing healthcare cost in order to maintain competitive healthcare plans for USG employees and retirees. Therefore, each institution’s Human Resources Department will validate supporting dependent documents when employees are hired, experience an eligible qualifying family status change and during the annual enrollment period.

Reason for Policy

This policy authorizes institutions to provide healthcare coverage to eligible dependents as defined by the Plan.

Entities Affected By This Policy

All units of the University System of Georgia are covered by this policy.

Who Should Read This Policy

All faculty and staff within the University System of Georgia should be familiar with this policy.

Contacts

Contact	Phone	Email/URL
Office of Human Resources	404-962-3235	usg-hr@usg.edu
Associate Vice Chancellor for Total Rewards	404-962-3248	karin.elliott@usg.edu
Institution Chief Human Resources Officers		See University System HR Officer Listing at http://www.usg.edu/inst/directories/hr/

Website Address for This Policy

None

Related Documents/Resources

None

Definitions

These definitions apply to these terms as they are used in this policy:

• See Appendix 1

Overview

This policy establishes processes/ procedures for the institution’s HR departments within the University System of Georgia, to validate documents for dependents enrolling in the USG healthcare plans. This policy ensures that only eligible dependents are covered under the USG healthcare plans, and that state-provided benefit dollars are allocated only to eligible individuals.

Process/Procedures

Employees may enroll themselves and their eligible dependents in the healthcare plans provided by the Board of Regents of the University System of Georgia. Employees must notify the institution’s HR Department and elect their healthcare benefits as follows:

• within thirty (30) days from hire date;
• within thirty (30) days of a qualified family status change (e.g. marriage, birth of a child, divorce) affecting the eligibility of dependents, and/or
• during the annual open enrollment period.

In all cases, documentation showing eligibility must be provided to the institution’s HR Department. If an employee does not provide the required documentation, his/her dependents cannot be covered.

Dependent Definitions & Documents Requirements

The eligibility definitions are determined by the Summary Plan Description (SPD) supplied by the University System of Georgia. The plan definitions are used to determine documentation requirements to ensure that each dependent originally met and continues to meet the eligibility rules defined by the plan.

The Board of Regents of the University System of Georgia shall have the right to determine eligibility of a spouse and dependents consistent with the provision of the plan.

• See Appendix 1

Annual Attestation

During the annual enrollment period employees will be required to provide an attestation validating eligible dependents. Employees knowingly and willfully making false or fraudulent statements to the Board of Regents of the University System of Georgia regarding dependents for healthcare coverage may be subject to institutional sanctions and a fine of not more than $1,000 or imprisonment for not less than one and no more than five years, or both and they may also lose health coverage for one year pursuant to O.C.G.A. Section 16-10.20.

Responsibilities

The responsibilities each party has in connection with the Policy on Group Health Insurance are:

Party	Responsibility
Vice Chancellor for Human Resources, USG	Ensure compliance with policy; maintain up-to-date list of required forms; provide guidance on meeting requirements. (This refers to forms…No forms required based on this policy. See below under forms).
Associate Vice Chancellor for Life and Health Benefits	Ensure compliance with policy; maintain up-to-date list of required forms, and provide guidance on meeting requirements.
Chief Audit Officer, USG	Periodically validate compliance with policy by conducting institutional audits.
Institution Chief Human Resources Officers	Ensure compliance with policy, establish institutional processes to comply.

Forms

None

Appendices

Appendix 1 – Dependent_Definitions_Document_Requirements_10-22-10.pdf

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