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: 801-366-7555 |
| : 800-765-7347 |
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As a new employee, how long do
I have to enroll in the health plan offered through PEHP by my employer? |
You have 60 days from the date you are employed
to enroll yourself and your eligible dependents.
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How do I enroll in the health plan? |
To enroll in PEHP’s health plan you must complete
the enrollment form
and return it to your Human Resource Department. Enrollment forms
may be obtained from your Human Resource Department.
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Who is eligible to be on the
health plans? |
- Your lawful spouse
- Unmarried children or step children up to the
age of 26 with whom you have a parental relationship.
- Unmarried legally adopted children, foster children,
and children through legal guardianship up to the age of 26 subject
to PEHP receiving adequate legal documentation.
- Unmarried children age 26 or older who are incapable
of self-support because of mental or physical handicap for as long
as they remain totally disabled, subject to your continued coverage.
Periodic medical documentation is required.
- Dependent children for whom you are required
to provide health insurance as stipulated in a divorce decree. Your
ex-spouse and/or stepchildren can no longer be covered under the
group plan, but may be eligible to convert to a COBRA plan.
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Will I have a pre-existing
condition waiting period? |
Utah Behavioral Healthcare Network has
a nine month pre-existing condition exclusion period. If, prior to enrolling
in PEHP, you have had health insurance coverage without a lapse in coverage
of 63 days or more, your prior coverage may be used to reduce your nine
month pre-existing condition exclusion period by the amount of time
you were covered under your previous insurance coverage. When enrolling,
PEHP will require a Certificate of Credible Coverage from your previous
provider of health insurance. Without the Certificate of Credible Coverage,
new enrollees may be subject to the full nine-month pre-existing condition
exclusion period.
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If I decline health coverage
during my initial eligibility period because of other health coverage and subsequently lose my health
coverage do I have to wait until the annual enrollment period
to enroll in the plans?
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If at the time of enrollment you are declining
enrollment for you or your eligible dependents (including your spouse)
because of other health insurance coverage and then subsequently lose
the other coverage, you may enroll yourself and your dependents in
PEHP, provided you request enrollment within 60 days after your other
coverage ends
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How long do I have to report
a change in family status (i.e., divorce, birth, adoption, marriage)
to PEHP? |
You have 60 days from the change in family status
to enroll any new dependent(s). If the change is not reported within
60 days you will have to wait until the next annual enrollment period
in order to enroll the new dependent(s).
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How long can my dependent
children remain on my health policy? |
An unmarried dependent child may remain on the
health policy until they reach age 26.
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May dependents under age 26 who are removed from coverage due to marriage or military duty be reinstated upon divorce or discharge from the military? |
A dependant child who marries and subsequently
divorces may not be added back onto your PEHP medical and/or dental
plan. A dependant who is discharged from the military prior to age 26
may be added back to your medical and/or plan within 60 days from the
date of discharge.
Under the dental policy anyone who is dropped from
the plan will have to wait three years until they may enroll again
and it must be done during the annual enrollment period.
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May I add my parents, who are dependent upon me for support to my health plans? |
A parent or parents who are dependent upon you
for support may not be added to your PEHP policy.
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If my employment terminates,
how can I continue coverage? |
A federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 "COBRA", requires that employers (with 20 or more employees) sponsoring group medical and/or dental plans offer employees and their eligible dependents that have elected coverage temporary extention of their medical and/or dental coverage. You are responsible for the total monthly rate plus 2 %. (PEHP administers COBRA coverage in accordance with Federal Law, 42 U.S.C. Section 300bb-1 et.seg.)
The Utah mini-COBRA is applicable if your employer has less than 20 employees. You and your eligible dependents that have had medical and/or dental coverage for at least 6 months prior to your termination date can continue your coverage for a period of six months. You are responsible for the total monthly rate plus 2%.( PEHP administers Utah mini-COBRA coverage in accordance with State Law, Utah Code Annotated. Section 31A-22-722).
Please refer to the PEHP Master Policy for more detailed information.
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