Opting Out of Coverage (full-time employees only)
In accordance with Public Act 92-0600, full-time employees may elect to opt out of the health coverage during the Initial Enrollment Period, the annual Benefit Choice Period or upon experiencing a qualifying change in status. The election to opt out of the health coverage includes, and will terminate, all employee and dependent health, dental, vision and prescription coverage. The employee will be enrolled in the Program with Basic Life coverage only, and will remain eligible to elect Optional Life coverage. Employees who elect to opt out of the Program must provide proof of other major medical insurance by an entity other than the Department of Central Management Services. Employees electing to opt out cannot be enrolled as a dependent in any plan administered by the Department. NOTE: An employee's application for other health coverage is not acceptable proof of other coverage.
Waiver Option (part-time employees only)
Eligible part-time employees may elect to waive coverage when they are required to pay a portion of the employer-paid contribution. These employees may waive their coverage during the Initial Enrollment Period, the annual Benefit Choice Period or upon experiencing a qualifying change in status. Part-time employees may not waive coverage and become a dependent of their State-employed spouse or civil union partner. The election to waive coverage remains in effect until the eligible employee becomes full-time, elects to enroll during the next annual Benefit Choice Period or experiences a qualifying change in status. Exception: Part-time employees who waived all coverage prior to July 1, 2003, and who have been continuously enrolled on their State-covered spouse's coverage, may continue to waive coverage and be covered as a dependent. This group of part-time employees is not eligible for life insurance coverage as a member.
Employees on Leave of Absence Waiving Coverage
Employees (full and part-time) on a leave of absence for which they are required to pay 100% of the cost of coverage (i.e., employee contribution plus the State's contribution) have the option to waive health and dental coverage, as well as drop any or all life coverage (including Basic Life, Member Optional Life, AD&D, Spouse Life and Child Life). The request to waive coverage must be made within 60 days of the leave effective date. The effective date of the waiver will be the date of the event or the date of the request, whichever is later.
The election to waive coverage remains in effect until the first day of the pay period following the date the eligible full-time employee physically returns to work. The employee will be reinstated with Basic Life coverage and the same employee health and dental coverage that they had prior to going on the leave. Eligibility to be enrolled as a dependent of their spouse or civil union partner ceases upon the employee's physical return to work; therefore, coverage for these members will be effective the date of the physical return.
The election to waive coverage remains in effect until the eligible part-time employee physically returns to work and requests coverage. Part-time employees who were enrolled in the Program prior to the leave and who request their coverage be reinstated upon returning to work will be reinstated with Basic Life coverage and the same health and dental coverage that they had prior to going on the leave. The request must be made within 60 days of the physical return to work and will be effective the first day of the pay period following the date of the request for coverage.
Opt out and waiver options for retirees differ from the options for employees. See the Retiree Opt Out/Waiver page for more information.