2005 Active Employee Health Insurance Handbook - Waiver of Coverage

You have the option to waive (decline) coverage if you do not want the health insurance offered through the Program.

If you are a new employee and wish to waive coverage, you must complete Sections I, II, #2, and VII of the health insurance application and turn it in to your agency's health insurance coordinator no later than thirty (30) days after your employment date.

If you are enrolled in a health insurance plan for 2004 and wish to waive coverage for 2005, you must complete Sections I, II, #2 and VII of the health insurance application during Open Enrollment.

If you waive coverage in 2004 and wish to waive coverage in 2005, you MUST complete a new application. You must complete Sections 1, II, #2 and VII of the health insurance application during Open Enrollment.

If you waive your health insurance provided by the Commonwealth, you may be eligible to receive a $234 employer contribution to direct into a Health Care Flexible Spending Account. However, in order to do so, you must enroll in a Flexible Spending Account.

• If you are a state employee, you are eligible for the Commonwealth Choice Health Care Flexible Spending Account. You must complete Section VI of the health insurance application.
• If you are an employee of any other agency, you may be eligible to direct the $234 employer contribution to a Health Care Flexible Spending Account. Contact your agency's health insurance coordinator for more information.

Retirees are not eligible for participation in a Flexible Spending Account Program.