Plan Administration Overview

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Eligibility:

• Employees working at least 30 hours per week for 50 weeks per year (1,500 annual hours).

​• Full-time teacher or other teacher working at least 30 hours per week during the school year (1,140 annual hours)

​• A non-teacher, school-year Employee working at least 30 hours per week during the school year (1,140 annual hours)

Additional family members eligible:

• Spouse

• Children, including stepchildren and children placed for adoption with the covered employee, who are up to 26 years old, regardless of student or marital status.

• Dependent Children of any age who are disabled or incapable of self support due to physical or mental disability.

Please Note:

If you and your spouse are employed within the Diocese of La Crosse and are eligible for the Diocese of La Crosse Lay Group Employee Medical Benefit Plan, you can be covered as an employee or as a dependent, but not both. Only one of you can cover your dependents.

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When To Enroll:

• Open Enrollment

• New employees – complete the Enrollment Form within 31 days of the employee’s first day of work.

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How To Make Changes:

• Unless you experience a Qualifying Event, changes to the plan cannot be made until the next open enrollment. If you experience a qualifying event, you have 31 days from the date of the event to make benefit changes.

Changes are made via the Enrollment - Change Form found in the document center.

Qualifying Events Include:

• Change with child’s dependent status

• Employment change

• Change in coverage or eligibility under another plan

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Coverage:

Benefits Become Effective:

• Open Enrollment - Effective beginning of plan year – January 1st

• New Employee - First day of the month following the first day of employment

• Qualifying Event - Either the first day of the event or the first day of the month following the qualifying event, depending on termination date of coverage previously provided .

• Terminated employees - May continue coverage on a self pay basis as outlined in the Continuation of Coverage section of the Summary of Plan Description found in our document center.

This information provided is an outline and guidelines of the Diocese of La Crosse Lay Ministry Group Employee Medical Benefit Plan and is not intended to be all inclusive.