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Madison Metropolitan School District

Employee Handbook 2021-2022

Addendum J: SECTION 7 INSURANCES

7.2 Health Insurance

Eligibility

Administrators/NUPS who are employed 50% FTE or more are eligible for health insurance coverage. Group insurance coverage shall be available the first day of the month following their eligibility date.

Employees will be considered “new employees” for eligibility purposes when they seek to enroll in the District group plan because of loss of their insurance coverage. A “new employee” under this section must submit application for insurance, with evidence of the qualifying event, within thirty (30) days of the loss of other coverage as a result of the following qualifying events: their spouse’s death; (2) their spouse’s termination of employment; (3) divorce; or (4) the reduction of one’s hours of work which results in the loss of eligibility of health insurance for the employee/spouse/dependent(s) via his/her employer, or (5) when the spouse of the employee, who has carried the family health insurance, experiences a significant reduction in benefits. Employees will also be considered “new employees” for eligibility purposes when their hours have been increased allowing them to qualify for health insurance benefits. They must submit application for insurance within thirty (30) days of receipt of the notification of increased hours.

The term “employees” when used for health insurance eligibility purposes shall refer only to current and eligible employees who seek to enroll in the District group plan and not to their spouses and/or dependents. Coverage under this section will become effective the first day following the termination date of the other coverage.

Contribution

The District currently offers the option of membership in one of two (2) qualified health maintenance organizations (HMO): Group Health Cooperative and Dean Health Plan. The District will also provide employees the additional option of membership in one of the approved Point of Service/Preferred Provider Organization (POS/PPO) plans as offered to District employees by each of the provided HMOs.

The District can require employees to make insurance premium contributions not to exceed 12% of the HMO monthly premium for both single and family coverage.

Termination

If employment ends with an effective date prior to the end of the school year, health insurance benefits cease the month in which the termination is effective.