Who may enroll?
All active, full‐time employees regularly scheduled to work a minimum of 30 hours per week and their eligible dependents may participate in Westminster School District’s benefits program. Eligible dependents include:
- Legal spouse or legally registered domestic partner (RDP)
- Children (natural, adopted, and step children) from birth up to the age of 26.
- A handicapped child over the age of 26, if they were actively enrolled in the plan at the time they became disabled/handicapped.
- Your registered domestic partner’s eligible children.
When you can enroll?
Eligible employees may enroll at the following times:
- As a new hire, you may participate in the District’s benefit plans on the first day of the month following your date of hire. Enrollment must take place within 30 days of hire.
Our benefit plans are effective October 1st through September 30th of each year. There is an annual open enrollment period each year, during which you can make new benefit elections for the following October 1st effective date. A new enrollment form is required each year, even if you do not plan to make any changes.
Changes to enrollment
You may only make changes to your benefit elections if you experience a qualified change in family status as defined by the IRS or if you qualify for a “special enrollment”. However; any changes you make must be consistent with the change in status. If you qualify for a mid-year benefit change, you may be required to submit proof of the change or evidence of prior coverage.
A qualified change in family status includes:
- Change in legal marital status, including marriage, divorce, legal separation, annulment, and death of a spouse.
- Change in number of dependents, including birth, adoption, placement for adoption, or death of a dependent child.
- Change in employment status that affects benefit eligibility, including the start or termination of employment by you, your spouse, or your dependent child.
- Change in work schedule, including an increase or decrease in hours of employment by you, your spouse, or your dependent child, including a switch between part-time and full-time employment that affects eligibility for benefits.
- Change in a child's dependent status, either newly satisfying the requirements for dependent child status or ceasing to satisfy them.
- Change in place of residence or work site, including a change that affects the accessibility of network providers.
- Change in your health coverage or your spouse's coverage attributable to your spouse's employment.
- Change in an individual's eligibility for Medicare or Medicaid.
- A court order resulting from a divorce, legal separation, annulment, or change in legal custody (including a Qualified Medical Child Support Order) requiring coverage for your child.
- An event that is a “special enrollment” under the Health Insurance Portability and Accountability Act (HIPAA) including acquisition of a new dependent by marriage, birth or adoption, or loss of coverage under another health insurance plan.
- An event that is allowed under the Children's Health Insurance Program (CHIP) Re-authorization Act. Under provisions of the Act, employees have 60 days after the following events to request enrollment: Employee or dependent loses eligibility for Medicaid (known as Medi-Cal in CA) or CHIP (known as Healthy Families in CA).
- Employee or dependent becomes eligible to participate in a premium assistance program under Medicaid or CHIP.
Two rules apply to making changes to your benefits during the year:
- Any changes you make must be consistent with the change in status, AND
- You must make the changes within 30 days of the date the event occurs (marriage, birth, etc.) unless otherwise noted above
Remember that coverage for a new spouse or newborn child is not automatic. If you experience a change in family status, you have 31 days to update your cover‐age. Please contact the Insurance Department immediately to complete the appropriate election forms as needed. If you do not update your coverage within 31 days from the family status change, you must wait until the next annual open enrollment period to update your coverage.