Eligibility

What you need to know

If you’re eligible for benefits, you can enroll yourself, your spouse or domestic partner, and/or your dependent children in medical, prescription drug, dental, and vision coverage—plus other voluntary and financial benefits. Your benefits are effective on your first day of employment or the day you become benefits eligible. If you change from part-time to full-time or vice versa, your premium changes will be effective the first of the month on or after 30 days of the status change.

Who’s Eligible for Coverage

You’re eligible for benefits if you’re a regular, full-time employee (36 or more hours per week) or a benefits-eligible part-time employee (generally 24–35 hours per week) of Westerly Hospital. Note: Under the YNHHS Medical Plan, eligibility is a minimum of 24 hours per week, and domestic partners are not covered.

If you’re eligible, you can also enroll:

  • Your legal spouse
  • Your domestic partner (in the HDHP Medical Plan only)
  • Your dependent children under age 26:
    • Biological children
    • Stepchildren
    • Adopted children, including those placed for adoption
    • Foster children
    • Any children for whom you are responsible per a court order
  • Your dependent children over age 26, if fully dependent on you for support due to a disability and covered by you prior to age 26

Supporting documentation required for dependents

To enroll your dependents, you’ll need to provide applicable supporting documentation such as a marriage certificate, birth certificate, court order, or federal income tax return. For details, visit HRConnect.

Coverage Under Multiple Plans (Coordination of Benefits—YNHHS Medical Plan only)

If you are enrolled in the YNHHS Medical Plan and you or members of your family are covered under more than one medical plan, your plan coordinates benefits to prevent duplication and overpayment of benefits. Here’s how that works:

When you (the employee) are the patient
Your plan will be the first to pay benefits. After you submit a claim, the other plan will then pay benefits according to its policies.
When your spouse/partner is the patient
His/her plan will pay benefits first. Then, your plan will pay its normal benefits, minus any benefits paid by your spouse/partner’s plan. If his/her plan pays benefits that are equal to or greater than the benefits your plan would otherwise pay, your plan will not pay benefits.
When your child is the patient and he or she is covered by your plan and your spouse/partner’s plan
The dates of your and your spouse/partner’s birthday will drive which plan pays benefits first. The plan of the person whose birthday occurs earlier in the year will pay benefits first. If your plan pays benefits second, its normal benefit will be reduced by the amount paid by the other plan.

Connect with…

HRConnect
Monday–Friday,
7:30 a.m. to 5 p.m. ET
844-543-2147
203-200-3838 (fax)
Website
Choose the YNHH_PRD option

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