The following information provides a summary of commonly asked questions, but you must consult your plan documents for full details about eligibility and coverage.
Q: I am a new hire. When do my benefits start?
A: At UNE your benefits start on the first day of the month after your hire date (the first day you worked); if your hire date is the first of the month, then your benefits begin on your first day of work.
Q: How do I know if I am eligible for benefits?
A: As outlined in the Summary Plan Descriptions, all regularly budgeted full- and half-time individuals are eligible for benefits. However, the Affordable Care Act provides that some part-time professional staff averaging 30+ hours per week may also become eligible for health benefits. You may also direct questions about eligibility to your Human Resources Representative.
Q: I don’t need medical insurance or any other benefits. Do I still need to meet with Human Resources?
A: Yes, whether you are electing or declining benefits you still need to meet with Human Resources and must complete the Benefit Election Form.
Q: Is my Domestic Partner eligible for benefits?
A: Yes, same-sex or opposite-sex Domestic Partners may participate in the University’s health and dental insurance programs if they meet the Domestic Partner qualifications and complete the Domestic Partner Affidavit. However, they may not participate with the same pre-tax advantages as couples who are married. Same-sex and opposite-sex married couples participate in the health and dental plans at the same levels.
Q: When can I make changes to my benefits?
A: Each year UNE offers an open enrollment period during which you can make changes to your benefits. This period typically lasts the month of November, and the resulting changes take place on January 1. You can also make changes within 30 days of a qualifying event. Qualifying events are generally life events that make you or one of your dependents eligible or ineligible for benefits; examples of qualifying events are marriage, divorce, start of new employment, end of previous employment, birth or adoption of a child, etc. You may need to provide documentation of the qualifying event to establish the eligible dates for making changes to your benefits package.
Q: I purchased UNE’s medical insurance. Do I have vision coverage?
A: Yes, your medical insurance includes vision coverage. Visit the vision section of our benefits website to view plan details and a list of in-network providers. If you also purchased dental insurance, there is an additional vision benefit that offers discounts but cannot be used at the same time as your vision benefits provided by your health coverage.
Q: How do I know if my provider is in the network or stops participating in the network?
A: You can go to the Harvard Pilgrim provider search link to view a list of in-network participating providers. Select "Standard Plans" and then "PPO" then search by your needs. If your health care provider has been participating in the plan but decides to leave the network, your provider’s office will notify you of the change. However, when you see your provider — especially if you see your provider infrequently — it is important to confirm that they are still participating in your plan network.
Q: I need to see a medical provider who is out of network. What are my financial responsibilities?
A: Except for emergency care at an emergency room, if you have an in-network plan (Basic or Enhanced), you will be responsible for 100% of the medical charges incurred outside the Harvard Pilgrim network. If you have the HSA plan, you have coverage on certain out-of-network procedures. Out-of-network coverage in the HDHP/HSA plan is generally 70%, but you should review the Summary of Benefits for more details.
Q: I am 65 years old and eligible for Medicare. Does UNE require me to sign up and drop my UNE medical coverage when I first qualify?
A: No, you have the option of canceling your UNE health coverage and taking your Medicare benefits or keeping both UNE health coverage and Medicare coverage. Southern Maine Agency on Aging is an excellent resource for information regarding Medicare, but you are welcome to contact your HR representative if you have questions regarding your UNE health insurance coverage once you turn 65.
Q: I recently moved and want to update my address with my health insurance carrier. What do I do?
A: If you have a change in your mailing address, please contact Human Resources immediately. We will need to update your address in our system and with the health and dental insurance carriers. If you previously participated in our TIAA-CREF retirement plan, you will need to contact TIAA-CREF directly; their number is (800) 842-2252.
Q: My child is over the age of 18. Can they remain on my health and dental insurance plans?
A: Yes, under the Affordable Care Act children may remain on your health and dental insurance plans until the end of the month they turn 26. This is also true if they are working or are married.
Q: If I enroll in the HSA plan in the upcoming year and have a Medical FSA in the current year, will the UNE grace period for the Medical FSA still apply?
A: No, all Medical FSA funds must be used and reimbursed by 12/31 if you have elected an HSA plan for the following calendar year.
Q: Can the HSA take the place of a Medical Flexible Spending Account?
Q: If I enroll in the HSA plan, can I still put funds into a Flexible Spending Account (FSA)?
A: No, if you are enrolled in an HSA medical plan a Medical FSA is not allowed. A Dependent Flexible Spending Account is allowed, however.