Kentucky Employees Health Plan - Benefits and Responsibilities Overview

 
1
 
DEI
 
 
 2
 
Course Map
Lesson 7: Transfers, Leaves, & Terminations
Wrap Up
 
IC Responsibilities
 
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Answer health, dental, vision, and life insurance questions and provide contact details where
they may receive additional information
A
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M
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Be familiar with and use the KEHP Administration Manual to complete your responsibilities as
an IC/BL in addition to processing and procedure guidelines for enrollment in the Kentucky
Employees’ Health Plan
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If your duties include Billing Liaison reconcile, process and release the health, dental, vision
and life premiums, administrative fees and flexible benefits all within Biller Direct
 
3
 
IC Responsibilities
 
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A copy of the Checklist for New Employees (located under “forms” then “miscellaneous” )
KEHP website 
http://kehp.ky.gov
Optional Insurance Branch website: 
https://personnel.ky.gov/pages/insurance.aspx
Training on benefits available, including the web address to obtain the Summary Plan
Descriptions: 
https://personnel.ky.gov/Pages/Dental.aspx
 for Dental Plans and
https://personnel.ky.gov/Pages/Vision.aspx
 for Vision Plans
 
4
 
 5
 
Course Map
Wrap Up
 
Plan Options
 
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:
Basic $20,000 Accidental Death & Dismemberment (AD&D) provided to all full time eligible employees by
the employer
 
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:
$5,000
$10,000
$25,000
$50,000
$100,000
$150,000
 
6
 
Dependent Plan Options
 
7
 
Benefit Highlights
 
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Basic and Optional Life include AD&D (accidental death and dismemberment)
Basic and Optional Life also covers death due to natural causes
E
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Employee passes due to an accident the beneficiary will receive $40,000 (insurance amount doubles)
Employee passes due to natural causes the beneficiary will receive $20,000 (amount of policy)
 
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AD&D also includes dismemberment coverage
Amount payable depends on the type of loss the employee experiences due to an accident
For Dismemberment Percentages and losses not covered for accidental death please refer to the
Booklet/Certificate of Coverage
 
https://personnel.ky.gov/KGLI/Life%20Insurance%20Booklet.pdf
 
8
 
Benefit Highlights
 
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An employee must have a life expectancy of 12 months or less
Employees premiums must be paid up to date to be eligible
The terminal illness proceeds are equal to 75% of what employee is currently enrolled in. (basic and
optional)
 
E
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Employee is enrolled in $20,000, they would receive $15,000 of benefit
Employee passes and the remaining balance of $5,000 would be paid out to the beneficiary, providing
the employee is still employed and not drawing any type of disability
 
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9
 
Dental and Vision Optional Insurance- Anthem
 
Dental and vision insurance is available to active employees.
Pre taxed
If a member elects health, dental and/or vision, the member will receive more than one card from Anthem.  For
example, the member may receive one card for health and one card for dental/vision depending on what they have
elected.
 
 
10
 
Dental
 
 
11
 
Vision
 
 
 
 
 
12
 
 13
 
Course Map
Wrap Up
 
Optional Insurance
 
Optional Insurance
 
15
 
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Optional Insurance
 
16
 
Optional Insurance
 
17
 
Optional Insurance
 
18
 
 19
 
Course Map
Wrap Up
 
Benefits Administration in KHRIS
 
Use KHRIS to manage the following benefit
types:
 
 
 
Medical
Waivers
Health
Reimbursement
Arrangements
(HRA)
 
 
 
 
Term Life and
Accidental Death
& Dismemberment
Life Accelerated
Death Benefit
Dental
Vision
 
 
L
i
f
e
(
G
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I
)
 
 
20
 
Health Care
Flexible
Spending
Account (FSA)
Child & Adult
Day Care
Flexible
Spending
Account (FSA)
 
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Flexible Spending
Accounts
Health
Optional
 
Who is Eligible?
 
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State Agencies
Boards of Education
Health Departments
Quasi Agencies
School Board Members (participate on a post-tax basis and are responsible for total
premiums). Participation in life insurance is not permitted.
 
21
 
Who is Eligible?
 
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Legally married spouse
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Single or married
Working or not
In school or not
Includes member’s child, step-child, adopted child, foster child or
grandchild who meets dependent eligibility criteria
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:
Children Under 26 rules do not apply for life insurance. In order for an
employee to cover a child over the age of 18, the dependent must be
enrolled in an educational institution and relying on the employee for
financial support or incapacitated. Proof of eligibility must be received
within 31 days of age limit.
 
 
22
 
Who is Eligible?
 
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May continue to be covered beyond the limiting age if:
The disability started before the limiting age
The disability is medically certified by a physician
 
If not covered prior to the limiting age, will be allowed to enroll only if the dependent
experiences loss of other coverage
All other eligibility requirements apply
You can request a Certification Form from Jeff Wiley at 502-564-1205 or 
jeffrey.wiley@ky.gov
Please refer to our Group Life Certificate booklet for requirements to cover a disabled
dependent for life insurance.
 
23
 
Who is Eligible?
 
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A foster child must have been placed by an authorized agency or court order
A grandchild may only be added with a court order
Superintendent with working spouse
Active employees and dependent spouses age 65 or older
 
Note:  All of these may require supporting documentation and are subject to signature date
guidelines.  Refer to current Administration Manual Appendix I for specifics.
 
24
 
Enrollment
 
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:
Enroll in a life insurance plan
Enroll in Anthem dental plan
Enroll in Anthem vision plan
**Coverage for new employees is effective on the first day of the
   second month following the date of hire
 
 
25
 
Enrollment
 
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Employees should enroll online via KHRIS ESS. They will receive a
new hire letter instructing them to do so. In addition, New Hire
Enrollment Steps are available on the website. If for some reason,
they are unable to complete their new hire enrollment online, they
may complete a paper application and provide to you to enter into
KHRIS.
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NOTE:  ICs who enroll an employee online MUST keep a copy of the
employee’s application on file.  DO NOT SEND APPLICATION TO EIB
or OIB.
 
26
 
Enrollment – New Hire
 
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KHRIS generates the employee’s KHRIS user ID
within 24-48 hours.  The IC will give the employee ID
to the employee as part of their new employee
orientation to enroll in their eligible benefits.
*
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27
 
Enrollment
 
To trigger a KHRIS User ID, the IC must complete the employee’s
“shell” in PA40
The employee is automatically enrolled into the Default LivingWell
Limited High Deductible Plan single level and the Basic Life
Insurance
New Hires will have 35 days from hire to enroll in any Optional
Plans
 
28
 
KHRIS User ID
 
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1.
 PA20 – “Basic personal data” tab
2.
 IT 00105 “Communication”
3.
 Click “Display
” and view the system ID
4.
 ID format: ABC1234
 
29
 
Who Can Enroll Online?
 
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:
Commonwealth Paid Employees
Non-Commonwealth Paid Employees
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:
Members with a disabled dependent
Qualifying events
Returning to Work Retirees
 
NOTE:  IC must complete hiring action (PA 40) for members
to enroll online
 
30
 
Enrollment – New Hire
 
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If there is a paper application submitted, the IC
must add dependents and beneficiaries
 
31
 
Enrollment – New Hire
 
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If there is a paper application submitted, the IC
completes the initial benefit enrollment in
KHRIS.
 
32
 
Enrollment
 
New employees who do not meet the enrollment deadline will be
defaulted to the LivingWell Limited High Deductible Plan at the single
level and Basic Life.
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Member will not be able to enroll in Dental or Vision coverage until
the next Open Enrollment period or unless a qualifying event is
experienced that will allow enrollment
The member may file an exception for Dental and Vision
If employee does not meet the life insurance enrollment deadline, the
employee will have to complete the EOI process and be approved by
the insurance company for additional coverage on themselves or their
spouse. However, they may pick up children at anytime.
 
 
33
 
COBRA
 
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New hires
New dependents
Transfers
New retirees
 
34
 
New Hire COBRA Notification
 
After an employee is hired into KHRIS or after an employee is entered into KHRIS,
WageWorks will then send the COBRA packet to the employee.
 
*
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t
e
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m
i
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a
t
i
o
n
s
.
 
Questions?
Contact 
Gregg.turner@ky.gov
 or 1-888-581-8834 Option 4
 
L
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I
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s
u
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a
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.
 
 
35
 
Special Enrollment
 
36
 
New Employee on Another Plan
 
37
 
Dual Employee
 
Represents an employee actively employed and eligible for
benefits under more than one KEHP or  participating employer.
 
38
 
Retirees Returning to Work
 
R
e
t
i
r
e
e
s
 
w
h
o
 
r
e
t
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L
i
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,
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e
n
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l
,
&
 
V
i
s
i
o
n
:
Has only one
personnel number
New Active Agency
      pernr
May enroll in ESS on
their active job only
(using new active
agency pernr )
 
 
39
 
Delete or Void
 
I
C
s
 
h
a
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e
 
t
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e
 
a
b
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t
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p
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;
 
h
o
w
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t
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y
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p
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d
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o
p
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s
.
 
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e
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e
 
b
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a
 
p
l
a
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N
e
v
e
r
 
v
o
i
d
 
a
 
p
l
a
n
 
 
 
If an employee quits prior to the benefit effective date, the
employee will need to be terminated in KHRIS.
 
40
 
 41
 
Course Map
Wrap Up
 
Optional Coverage Premium
 
KHRIS automatically re-calculates the optional coverage
premiums for an employee when he/she moves from one of the
following age groups to another:
 
 
42
 
Life Plans - Evidence of Insurability (EOI)
 
 
 
Participants can request to add
or increase life plans without a
qualifying event by submitting
an Enrollment Change
Termination Form.  IC will
forward to OIB to initiate the
EOI process. Please do not
start payroll deductions until
employee has been approved.
If the employee is approved the
new deduction will appear on
your next months bill, following
approval.
 
 
N
o
t
e
:
 
 
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O
I
 
i
s
 
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e
l
i
g
i
b
i
l
i
t
y
,
 
c
a
l
l
 
G
L
I
.
 
43
 
Life Beneficiary
 
A
n
 
e
m
p
l
o
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e
 
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a
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c
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h
i
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a
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y
 
i
n
 
E
S
S
:
After the employee has completed the designation of Beneficiary Form, the IC may add
or change the beneficiaries on an employee’s life insurance plan.  (ICs should print
confirmation in HRBEN0015 for the employee – this confirmation is for the employee to
see that everything was entered correctly).  It’s recommended to have the employee sign
the confirmation.
When selecting beneficiaries for life, use the following from the drop down list:
1
 
 
S
p
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2
 
 
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              signature date on beneficiary form
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:
 
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c
a
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t
 
44
 
 45
 
Course Map
Wrap Up
 
Qualifying Event -  Dental & Vision
 
A qualifying event is a life changing event which allows a permitted change to
health or life insurance elections or FSA contributions, outside of the open
enrollment period.
 
ICs must always notify the Enrollment Information Branch of the following
qualifying events:
 
 
H
e
a
l
t
h
 
a
n
d
/
o
r
 
F
S
A
 
Q
u
a
l
i
f
y
i
n
g
 
E
v
e
n
t
s
 
*More specific information can be found in your Admin Manual in  Appendix I
 
46
Consult the
Administrative
Manual Appendix I
for
QEs
Mid-year scenarios
Dependent
Eligibility Chart
 
Qualifying Events- Life
 
 
ICs must always notify OIB of qualifying events:
 
L
i
f
e
 
I
n
s
u
r
a
n
c
e
 
Q
E
s
Children can be
    added at ANY time
Marriage
Death
Employee may term life plans at anytime
 
47
 
Qualifying Events
 
When an employee experiences a qualifying event, the employee will
complete the appropriate form.  The forms can be obtained at:
T
he OIB website:
    
https://personnel.ky.gov/Pages/Insurance.aspx
Once the employee has gathered the supporting documentation,
completed, signed and dated the form; the employee must submit the form
to his/her IC
 
*
P
l
e
a
s
e
 
u
s
e
 
c
u
r
r
e
n
t
 
f
o
r
m
s
 
f
o
r
 
2
0
2
0
 
48
 
Forms
 
49
 
Forms
 
50
 
Qualifying Events
 
T
h
e
 
t
i
m
i
n
g
 
o
f
 
t
h
e
 
s
i
g
n
a
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d
a
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m
u
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c
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a
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s
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a
p
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f
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t
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d
a
t
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d
e
a
d
l
i
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e
 
o
f
 
3
5
 
d
a
y
s
The only exception is gaining Medicaid which has a signature date of 60
days
T
h
e
 
e
m
p
l
o
y
e
e
 
d
o
e
s
 
N
O
T
 
n
e
e
d
 
t
o
 
w
a
i
t
 
f
o
r
 
a
n
y
 
s
u
p
p
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t
i
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g
d
o
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a
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t
o
 
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f
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e
 
t
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f
o
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m
 
i
s
 
s
i
g
n
e
d
The IC will submit the form to OIB for Optional insurance:
Once the supporting documentation is received
The employee and IC have signed and dated the form
 
 51
 
*
P
l
e
a
s
e
 
u
s
e
 
c
u
r
r
e
n
t
 
f
o
r
m
s
 
f
o
r
 
2
0
2
0
 
Qualifying Events
 
 
Q
u
a
l
i
f
y
i
n
g
 
E
v
e
n
t
s
 
t
h
a
t
 
a
l
l
o
w
 
p
r
e
-
s
i
g
n
i
n
g
 
t
o
 
t
h
e
 
e
v
e
n
t
 
t
a
k
i
n
g
 
p
l
a
c
e
 
a
r
e
:
Loss of other coverage
Gaining other group coverage
Entitlement to Medicare; or
Experiencing a different open enrollment period
 
T
h
e
 
c
h
a
n
g
e
s
 
a
r
e
 
t
y
p
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c
a
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l
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s
t
 
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o
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a
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o
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.
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o
 
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u
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v
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t
 
t
a
k
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g
 
p
l
a
c
e
.
 
52
 
Qualifying Events
 
T
h
e
 
Q
u
a
l
i
f
y
i
n
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E
v
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t
 
d
a
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d
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a
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p
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d
a
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i
s
 
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y
 
a
c
c
e
p
t
e
d
 
f
o
r
Entitlement to CHAMPVA or TRICARE
Entitlement to government programs such as Medicare and
Medicaid
 
 
53
 
Rejecting Applications –  IC Memo 17-14
 
W
e
 
w
i
l
l
 
r
e
j
e
c
t
 
a
n
y
 
a
p
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A
p
p
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m
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c
o
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t
 
f
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m
,
 
c
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e
n
t
i
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a
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d
 
h
a
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t
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r
e
q
u
i
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d
 
s
u
p
p
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r
t
i
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g
d
o
c
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t
a
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i
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n
 
a
t
t
a
c
h
e
d
 
(
e
x
a
m
p
l
e
:
 
l
o
s
s
 
o
f
 
o
t
h
e
r
 
c
o
v
e
r
a
g
e
 
d
o
c
u
m
e
n
t
a
t
i
o
n
)
New hires and most QEs have 35-days from the hire date or QE date to sign the
application (gain of Medicaid has 60-days)
I
C
s
 
m
u
s
t
 
s
u
b
m
i
t
 
t
h
e
 
Q
E
 
t
o
 
t
h
e
 
E
I
B
 
w
i
t
h
i
n
 
4
5
-
d
a
y
s
 
f
r
o
m
 
t
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e
v
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t
 
d
a
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(
7
0
-
d
a
y
s
 
f
o
r
g
a
i
n
 
o
f
 
M
e
d
i
c
a
i
d
)
We will reject the application if it is not received within the required timeframe
We will email the IC who signed the application
 
54
 
Benefits Administration Contacts – EIB and OIB
 
p
e
r
s
o
n
n
e
l
.
g
r
o
u
p
l
i
f
e
i
n
s
u
r
a
n
c
e
@
k
y
.
g
o
v
 
General questions
Questions regarding Rejected Applications
Not to be used for submitting new applications. However, you can resubmit rejected
applications with the required documentations.
It is monitored for more efficient processing
Will get a response within 24-48 hours depending on volume, phone and applications to be
processed
 
 
 55
 
 56
 
Course Map
Wrap up
 
Transfer Process in KHRIS
 
57
 
Transfers
 
A
 
T
r
a
n
s
f
e
r
 
t
a
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e
s
 
p
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e
 
w
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w
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E
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The effective date of the coverage will depend on the type of transfer member experienced:
Clean Transfer - 0 day
Small Break Transfer - 1 to 10 working days
11+ days Break Transfer – Considered a new hire, 1
st
 day of the 2
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Please refer to Administration Manual, Chapters 2 & 6 for guidelines regarding Transfers
and effective dates for coverage
 
58
 
Return from Leave Without Pay (Life)
 
When an employee returns from approved LWOP, OIB processes life insurance reinstatements using
the following guidelines:
 
 
 
 
 
 
 
 
Please make sure you notify your employees they’re able to pay life premiums while on LWOP up to
one year.
 
59
 
Return from Leave Without Pay (Dental and Vision)
 
 
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Begin Official LWOP – Coverage stops at the end of the month in which LWOP began.
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60
 
Terminations
 
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Life Insurance will always term at the end of the month
Dental & Vision will always term at the end of the month
Process all terminations in MUNIS and KHRIS
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61
 
Benefits Administration Contacts – Health
 
62
 
 63
 
Course Map
Wrap up
 
Questions & Answers
 
64
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Explore the Kentucky Employees Health Plan (KEHP) for comprehensive insurance coverage details, including responsibilities, benefits offered, online tools, administration guidelines, optional insurance benefits, qualifying events, and more. Access resources such as the KEHP website, new employee checklist, and training materials for a smooth enrollment process.


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  1. DEI KEHP OIB KHRIS 1

  2. Course Map Lesson 1: IC Responsibilities Lesson 2: Benefits Offered Lesson 3: On-Line Tools Lesson 4: Benefits Administration Lesson 5: Optional Insurance Benefits Lesson 6: Qualifying Events Lesson 7: Transfers, Leaves, & Terminations Wrap Up 2

  3. IC Responsibilities Counsel Employees Answer health, dental, vision, and life insurance questions and provide contact details where they may receive additional information Administration Manual Be familiar with and use the KEHP Administration Manual to complete your responsibilities as an IC/BL in addition to processing and procedure guidelines for enrollment in the Kentucky Employees Health Plan Manage Monthly Bills If your duties include Billing Liaison reconcile, process and release the health, dental, vision and life premiums, administrative fees and flexible benefits all within Biller Direct 3

  4. IC Responsibilities Provide the following to your new employees A copy of the Checklist for New Employees (located under forms then miscellaneous ) KEHP website http://kehp.ky.gov Optional Insurance Branch website: https://personnel.ky.gov/pages/insurance.aspx Training on benefits available, including the web address to obtain the Summary Plan Descriptions: https://personnel.ky.gov/Pages/Dental.aspx for Dental Plans and https://personnel.ky.gov/Pages/Vision.aspx for Vision Plans 4

  5. Course Map Lesson 1: IC Responsibilities Lesson 2: Benefits Offered Lesson 3: On-Line Tools Lesson 4: Benefits Administration Lesson 5: Optional Insurance Benefits Lesson 6: Qualifying Events Lesson 7: Transfers, Leave, & Terminations Wrap Up 5

  6. Plan Options Life Insurance Options for employee include: Basic $20,000 Accidental Death & Dismemberment (AD&D) provided to all full time eligible employees by the employer Additional AD&D Plans employee may purchase for themselves: $5,000 $10,000 $25,000 $50,000 $100,000 $150,000 6

  7. Dependent Plan Options 7

  8. Benefit Highlights Basic and Optional Life AD&D Basic and Optional Life include AD&D (accidental death and dismemberment) Basic and Optional Life also covers death due to natural causes Example Employee passes due to an accident the beneficiary will receive $40,000 (insurance amount doubles) Employee passes due to natural causes the beneficiary will receive $20,000 (amount of policy) Dismemberment Coverage AD&D also includes dismemberment coverage Amount payable depends on the type of loss the employee experiences due to an accident For Dismemberment Percentages and losses not covered for accidental death please refer to the Booklet/Certificate of Coverage https://personnel.ky.gov/KGLI/Life%20Insurance%20Booklet.pdf 8

  9. Benefit Highlights Accelerated Death Benefit for Basic and Optional Life Coverage An employee must have a life expectancy of 12 months or less Employees premiums must be paid up to date to be eligible The terminal illness proceeds are equal to 75% of what employee is currently enrolled in. (basic and optional) Example Employee is enrolled in $20,000, they would receive $15,000 of benefit Employee passes and the remaining balance of $5,000 would be paid out to the beneficiary, providing the employee is still employed and not drawing any type of disability Dependent Life Plans are not covered under the AD&D or Accelerated Death Benefit plan options 9

  10. Dental and Vision Optional Insurance- Anthem Dental and vision insurance is available to active employees. Pre taxed If a member elects health, dental and/or vision, the member will receive more than one card from Anthem. For example, the member may receive one card for health and one card for dental/vision depending on what they have elected. 10

  11. Dental 11

  12. Vision 12

  13. Course Map Lesson 1: IC Responsibilities Lesson 2: Benefits Offered Lesson 3: On-Line Tools Lesson 4: Benefits Administration Lesson 5: Optional Insurance Benefits Lesson 6: Qualifying Events Lesson 7: Transfers, Leave, & Terminations Wrap Up 13

  14. Optional Insurance

  15. Optional Insurance https://personnel.ky.gov/Pages/Insurance.aspx 15

  16. Optional Insurance 16

  17. Optional Insurance 17

  18. Optional Insurance 18

  19. Course Map Lesson 1: IC Responsibilities Lesson 2: Benefits Offered Lesson 3: On-Line Tools Lesson 4: Benefits Administration Lesson 5: Optional Insurance Benefits Lesson 6: Qualifying Events Lesson 7: Transfers, Leave, & Terminations Wrap Up 19

  20. Benefits Administration in KHRIS Use KHRIS to manage the following benefit types: Flexible Spending Accounts Life (GLI) Health Optional Medical Waivers Health Reimbursement Arrangements (HRA) Term Life and Accidental Death & Dismemberment Life Accelerated Death Benefit Dental Vision Health Care Flexible Spending Account (FSA) Child & Adult Day Care Flexible Spending Account (FSA) 20

  21. Who is Eligible? Full time employees of the following agencies who contribute to a state sponsored retirement system State Agencies Boards of Education Health Departments Quasi Agencies School Board Members (participate on a post-tax basis and are responsible for total premiums). Participation in life insurance is not permitted. 21

  22. Who is Eligible? Employee Spouse Legally married spouse Employee child under age 26 Single or married Working or not In school or not Includes member s child, step-child, adopted child, foster child or grandchild who meets dependent eligibility criteria Group Life Insurance: Children Under 26 rules do not apply for life insurance. In order for an employee to cover a child over the age of 18, the dependent must be enrolled in an educational institution and relying on the employee for financial support or incapacitated. Proof of eligibility must be received within 31 days of age limit. 22

  23. Who is Eligible? Disabled dependent children May continue to be covered beyond the limiting age if: The disability started before the limiting age The disability is medically certified by a physician If not covered prior to the limiting age, will be allowed to enroll only if the dependent experiences loss of other coverage All other eligibility requirements apply You can request a Certification Form from Jeff Wiley at 502-564-1205 or jeffrey.wiley@ky.gov Please refer to our Group Life Certificate booklet for requirements to cover a disabled dependent for life insurance. 23

  24. Who is Eligible? Other considerations A foster child must have been placed by an authorized agency or court order A grandchild may only be added with a court order Superintendent with working spouse Active employees and dependent spouses age 65 or older Note: All of these may require supporting documentation and are subject to signature date guidelines. Refer to current Administration Manual Appendix I for specifics. 24

  25. Enrollment New employees have 35 calendar days from their date of hire to make elections online through KHRIS ESS or complete an enrollment application electing one of the following: Enroll in a life insurance plan Enroll in Anthem dental plan Enroll in Anthem vision plan **Coverage for new employees is effective on the first day of the second month following the date of hire 25

  26. Enrollment The KHRIS system counts exactly 35 calendar days beginning with the day after the hire date Employees should enroll online via KHRIS ESS. They will receive a new hire letter instructing them to do so. In addition, New Hire Enrollment Steps are available on the website. If for some reason, they are unable to complete their new hire enrollment online, they may complete a paper application and provide to you to enter into KHRIS. ICs may enroll the employee in KHRIS provided the employee completed the application and signed it within 35 days ID cards will be mailed to the employee s home address 10-14 business days after the enrollment is processed in KHRIS NOTE: ICs who enroll an employee online MUST keep a copy of the employee s application on file. DO NOT SEND APPLICATION TO EIB or OIB. 26

  27. Enrollment New Hire 1 Personnel Action PA40 IC performs the new hire action in KHRIS to create an employee record KHRIS generates the employee s KHRIS user ID within 24-48 hours. The IC will give the employee ID to the employee as part of their new employee orientation to enroll in their eligible benefits. *Note: New employee or employees going from PT<100 to PT>100 or FT should be given a full New Employee Packet. *Refer to the Admin Manual for the KEHP Insurance and Flexible Spending Account Checklist for New Employees 27

  28. Enrollment To trigger a KHRIS User ID, the IC must complete the employee s shell in PA40 The employee is automatically enrolled into the Default LivingWell Limited High Deductible Plan single level and the Basic Life Insurance New Hires will have 35 days from hire to enroll in any Optional Plans 28

  29. KHRIS User ID ICs can look up KHRIS user IDs 1. PA20 Basic personal data tab 2. IT 00105 Communication 3. Click Display and view the system ID 4. ID format: ABC1234 29

  30. Who Can Enroll Online? The following members can enroll online: Commonwealth Paid Employees Non-Commonwealth Paid Employees The following must use a paper application: Members with a disabled dependent Qualifying events Returning to Work Retirees NOTE: IC must complete hiring action (PA 40) for members to enroll online 30

  31. Enrollment New Hire This action is completed after the New Hire Action: 2 PA30 Employee enrolls through ESS or submits paperwork to IC for processing If there is a paper application submitted, the IC must add dependents and beneficiaries 31

  32. Enrollment New Hire This action is completed after the New Hire Action: 3 HRBEN001 Enrollment Employee enrolls through ESS or submits paperwork to IC for processing. If there is a paper application submitted, the IC completes the initial benefit enrollment in KHRIS. 32

  33. Enrollment New employees who do not meet the enrollment deadline will be defaulted to the LivingWell Limited High Deductible Plan at the single level and Basic Life. KHRIS will automatically enroll the member into the Basic Life Insurance Plan Member will not be able to enroll in Dental or Vision coverage until the next Open Enrollment period or unless a qualifying event is experienced that will allow enrollment The member may file an exception for Dental and Vision If employee does not meet the life insurance enrollment deadline, the employee will have to complete the EOI process and be approved by the insurance company for additional coverage on themselves or their spouse. However, they may pick up children at anytime. 33

  34. COBRA COBRA is a federal law that requires all employers to provide continuation of medical coverage at group rates in certain instances where there is a loss of group insurance coverage Timely entry into MUNIS or KHRIS is important to generate all notices to members New hires New dependents Transfers New retirees 34

  35. New Hire COBRA Notification After an employee is hired into KHRIS or after an employee is entered into KHRIS, WageWorks will then send the COBRA packet to the employee. *ICs are not responsible for notifying WageWorks COBRA of qualifying events and separations such as retirements and terminations. Questions? Contact Gregg.turner@ky.gov or 1-888-581-8834 Option 4 Life Insurance *IC is responsiblefor notifying employee they re able to covert their life insurance, if their employment terminates. You may use transaction ZBNF002 in KHRIS to generate a letter. Please refer to the Benefits User Guide for step by step instructions. 35

  36. Special Enrollment New employee covered on other plan Cross- references Dual Employment Retirees returned to work 36

  37. New Employee on Another Plan New employee covered on someone else s plan Child Spouse The system determines if the new employee is a child between the ages of 19-25 currently covered under another KEHP plan (child will be dropped automatically at the end of the month they turn 26) No Dental or Vision Plans will be offered until the new employee (child) has been dropped from the other plan The system determines if the spouse is already covered under a KEHP Plan. No Dental or Vision Plans will be offered until the new employee (spouse) has been dropped from the other plan 37

  38. Dual Employee Represents an employee actively employed and eligible for benefits under more than one KEHP or participating employer. Employee Receives two active personnel numbers; one for each position Benefits Administration NOTE: Infotypes 2, 6, 21, 376, and 105 (email subtype) share information across all personnel numbers for the employee. Data changes made to one of these infotypes automatically updates the same infotype of the other personnel number. If benefit eligible under both employers: Receives two employer contributions for health coverage and one contribution for life, dental, and vision coverage Can enroll online with ESS to display benefits for both personnel numbers 38

  39. Retirees Returning to Work Retirees who return to work Life, Dental,& Vision: Has only one personnel number New Active Agency pernr May enroll in ESS on their active job only (using new active agency pernr ) 39

  40. Delete or Void ICs have the ability to delete or void benefit plans; however, they should NEVER process a plan correction using the delete options. Never click the Delete button to delete a plan Never void a plan If an employee quits prior to the benefit effective date, the employee will need to be terminated in KHRIS. 40

  41. Course Map Lesson 1: IC Responsibilities Lesson 2: Benefits Offered Lesson 3: On-Line Tools Lesson 4: Benefits Administration Lesson 5: Optional Insurance Benefits Lesson 6: Qualifying Events Lesson 7: Transfers, Leave, & Terminations Wrap Up 41

  42. Optional Coverage Premium KHRIS automatically re-calculates the optional coverage premiums for an employee when he/she moves from one of the following age groups to another: <40 years 40-59 years 60+ years 42

  43. Life Plans - Evidence of Insurability (EOI) Participants can request to add or increase life plans without a qualifying event by submitting an Enrollment Change Termination Form. IC will forward to OIB to initiate the EOI process. Please do not start payroll deductions until employee has been approved. If the employee is approved the new deduction will appear on your next months bill, following approval. Note: EOI is not required for children. Any questions concerning eligibility, call GLI. 43

  44. Life Beneficiary An employee may change his/her beneficiary at any time in ESS, this is the preferred method The following instructions are to be used for individuals needing technical assistance, or for those who are otherwise unable to complete a Designation of Beneficiary in ESS: After the employee has completed the designation of Beneficiary Form, the IC may add or change the beneficiaries on an employee s life insurance plan. (ICs should print confirmation in HRBEN0015 for the employee this confirmation is for the employee to see that everything was entered correctly). It s recommended to have the employee sign the confirmation. When selecting beneficiaries for life, use the following from the drop down list: 1 Spouse / 2 Child / 9003 Other Beneficiaries Note 1: If a new beneficiary needs to be entered to IT0021 in PA30, use the signature date of updated beneficiary form to add them Note 2: When completing HRBEN0001, the start date must be same as signature date on beneficiary form Note 3: If the Employee is unable to enter the beneficiary in ESS or the IC is unable to enter in KHRIS; a Designation of Beneficiary form must be completed, signed and dated. The IC should file the original in the employee s personnel file and provide the employee a copy Note 4: OIB should enter beneficiaries if the agency can t 44

  45. Course Map Lesson 1: IC Responsibilities Lesson 2: Benefits Offered Lesson 3: Online Tools Lesson 4: Benefits Administration Lesson 5: Optional Insurance Benefits Lesson 6: Qualifying Events Lesson 7: Transfers, Leave, & Terminations Wrap Up 45

  46. Qualifying Event - Dental & Vision A qualifying event is a life changing event which allows a permitted change to health or life insurance elections or FSA contributions, outside of the open enrollment period. ICs must always notify the Enrollment Information Branch of the following qualifying events: Health and/or FSA Qualifying Events Consult the Administrative Manual Appendix I for QEs Mid-year scenarios Dependent Eligibility Chart Marriage Birth / adoption / placement Court order for child Divorce / separation / annulment (Lose Spouse) * Starting Employment Termination of Employment Death / Death of dependent Dependent becomes ineligible (26) Dependent reestablishes eligibility Begin/End Medicare / Medicaid Special enrollment due to eligibility for state premium assistance subsidy Begin/End paid leave Loss of group health Loss of eligibility for individual health coverage (Marketplace) Retiree open enrollment Military leave Resident child care change (dependent day care) Other open enrollment Other employer plan decreases or ceases coverage Other permitted *More specific information can be found in your Admin Manual in Appendix I 46

  47. Qualifying Events- Life ICs must always notify OIB of qualifying events: Life Insurance QE s Children can be added at ANY time Marriage Death Employee may term life plans at anytime 47

  48. Qualifying Events When an employee experiences a qualifying event, the employee will complete the appropriate form. The forms can be obtained at: The OIB website: https://personnel.ky.gov/Pages/Insurance.aspx Once the employee has gathered the supporting documentation, completed, signed and dated the form; the employee must submit the form to his/her IC *Please use current forms for 2020 48

  49. Forms 49

  50. Forms 50

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