Benefit Eligible Employees

Employees working 20 hours or more per week are eligible to participate in the benefit program. 

 

Eligible Dependents

Your eligible dependents include:

• Your spouse (unless you are legally separated)

• Your registered domestic partner

• Your dependent children, up to age 26 regardless of their student or marital status

• Adopted, foster or domestic partner’s children

• Your dependent children, if they are incapable of self-support due to physical or mental disability 

 

Coverage may be available for a mentally or physically disabled child who is age 26 or older. Requirements for such coverage and documentation of disability depend on the insurance carrier. Please contact benefits@syhealth.org if you believe this applies to your family.

 

When You Can Enroll

New Hires/Newly Eligible for Benefits

You are eligible for benefits on the first day of the month after 30 days worked. You have 30 days from the date of your hire to enroll in benefits. After your initial enrollment, you will have the opportunity to re-enroll in the benefits program each year during the Annual Open Enrollment period, unless you have a Qualifying Life Event. Be prepared to show documentation for qualifying event, such as marriage license, birth certificate or divorce decree.

 

Qualifying Life Event Change

During the annual open enrollment period, you will have the opportunity to make any changes in your coverage(s) for the next plan year. Please keep in mind that you will have 30 days from the event date to make any changes and notify the Benefits Team of any changes. Plan year begins May 1, 2024 and is in effect through April 30, 2025. 

 

After the annual enrollment period, you will only be able to change your coverage if you have a qualifying life event. Qualifying life events include, but are not limited to:

• Change in your employment status (commencement, termination, reduction in hours from full-time of 20 hours/week to part-time 19 hours or less or vice versa) or change to per diem employment

• Change in marital status (marriage, death of spouse, divorce, legal separation) 

• Change in dependents (birth, death, adoption, and child support order) 

• Special enrollment rights under Health Insurance Portability Accountability Act (“HIPAA”)

• Medicare or Medicaid entitlement for you, your spouse, or dependent (60 days)

 

When Coverage Ends

If your employment at San Ysidro Health ends, your medical, dental, and vision coverage will end on the last day of the month of your termination date. Other circumstances which may result in termination of coverage for you and/or your dependents include: reduction in regular hours, divorce/legal separation, and dependent children who reach age 26. Your FSA will terminate on the date of termination.

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