8.27 – Vision Insurance

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Details

Scope: NMSU System

Source: ARP Chapter 8 | HR-Benefits

Rule Administrator:

Last Updated: 06/27/2016

Related

Cross-Reference:

Revision History:

2017 Recompilation, formerly Rule 7.15.40
06/27/2016 Change in Benefits approved by Board of Regents
06/21/2016 Change in Benefits approved by Chancellor
10/21/2015 Policy 7.15.05 approved as initial Rule 7.15.05 approved by Board of Regents
06/20/2013 Amendment to 7.15.05 approved by Board of Regents

A. Eligibility


The university offers vision insurance for all eligible employees.  Effective July 1, 2016, eligible employees are defined as those employees working at least .75 FTE in a regular, nine-month, or term appointment position.  Optional dependent coverage is also available to eligible employees.  Nine -month regular employees will receive full benefits, except for unemployment compensation, during the off employment period provided they return to employment the following academic year.  Eligible employees also include any employee continuously enrolled in this benefit from June 30, 2016.

Employees working in a position less than a .75 FTE; temporary employees; graduate assistants; other student employees; and Cooperative Extension Service employees with federal appointments are not eligible to participate in the group policy.

 

B. Effective Date of Coverage and Enrollment Procedures


Coverage is optional and is available from the date of eligible employment.  Coverage is effective the first of the month after 30 days of employment. Employees must complete and return an enrollment form to the Office of Human Resource Services within 31 calendar days of their date of employment to receive this benefit without late enrollment provisions.

 

C. Premium Payments


Premium payments are made by payroll deduction, and the employee pays 100% of the premium. Premium payments begin the pay period in which coverage begins.

 

D. Coverage Changes


An employee is responsible for requesting changes to vision coverage by completing and submitting appropriate forms in order to adjust premiums.  When an employee experiences a change in status, the employee has 31 calendar days from the date of the status change to contact the Office of Human Resource Services to make coverage changes.

  1. A change in status includes, but is not limited to:
    1. Marriage
    2. Divorce
    3. Childbirth or adoption
    4. Loss of prior coverage or gain of new coverage
    5. Dependent no longer meeting insurance eligibility rules due to age or marriage
  2. All status changes which result in an insurance coverage and/or premium change will be effective the first day of the month following the date of the change in status.
  3. All changes that affect premiums will result in a full premium being deducted for the pay period in which the change takes place.

 

E. Coverage After Retirement or Termination


Coverage ceases at midnight on the 15th day of the month if employment terminates between the 1st and 15th day of the month, provided the applicable premium for the pay period has been paid. If an employee terminates employment between the 16th and last day of the month, coverage ceases at midnight on the last day of the month, provided the applicable premium for the pay period has been paid. The policy contains continuance in compliance with state and federal law.

 

F. Coverage During Leave Without Pay


During periods of leave without pay vision may be continued at the option of the employee. Continued coverage cannot exceed the length of time agreed upon by the individual vendor agreements. Arrangement for payment of premiums will be made with the Office of Human Resource Services and the university Accounts Receivable Office. If premiums are not paid coverage will end as of the last date premiums were paid. If coverage is not continued or is canceled during leave without pay, the employee will be required to re-apply for coverage as a late enrollee upon return to work. Reinstatement of coverage is not automatic and is subject to approval from the carrier. If the employee is on LWOP for more a full pay period the employee is responsible for both the university’s and employee’s portion of premiums (except FMLA, Professional LWOP and Educational LWOP).

 

G. Discontinuing Coverage


An employee who discontinues coverage and then wishes to re-enroll in the future will be required to follow late enrollment requirements.