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Insurance Benefit Overview
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Eligibility
If you're appointed to work at least 20 hours or more a week for at least 4.5 months (135 calendar days) in an eligible staff, faculty or graduate student academic employee position, you may participate in the university's insurance plans.
Certain non-employee Postdoctoral Fellows and Graduate Student Fellows are eligible to participate in the university’s medical, dental and vision insurance plans. Review the following for more information about eligibility.
For UT SELECT Medical ONLY, your eligible dependents are:
- Your spouse as defined by the Texas Family Code;
- Your child(ren) under age 26, including stepchildren, adopted children, and children for whom you are the legal guardian or who are the subject of a medical support order;
- Your unmarried grandchild under age 25, if the child qualifies and is claimed as your dependent for federal tax purposes; and
- Certain children over age 26, who are determined by the UT System Office of Employee Benefits (OEB) to be medically incapacitated and are unable to provide their own support.
For all Voluntary UT Benefits (other than UT SELECT Medical), your eligible dependents are:
- Your spouse as defined by the Texas Family Code;
- Your unmarried child(ren) under age 25, including stepchildren, adopted children, and children for whom you are the legal guardian or who are the subject of a medical support order;
- Your unmarried grandchild under age 25, if the child qualifies and is claimed as your dependent for federal tax purposes; and
- Certain children over age 25, who are determined by OEB to be medically incapacitated and are unable to provide their own support.
Examples of dependents who aren't eligible for coverage:
- Your common-law spouse, unless you have a Declaration of Informal Marriage;
- Your opposite-sex or same-sex domestic partner;
- Your former spouse;
- Your married child, for coverage other than UT SELECT Medical;
- Your grandchild, if married or over age 25;
- Your child over age 25 (age 26 for UT SELECT Medical), if not medically incapacitated and unable to provide their own support;
- Foster children who are covered by another government program, unless required by law or court order;
- Any child for whom you only have power of attorney;
- Any dependent insured by another university employee or retired employee;
- Any dependent insured by another plan that receives State of Texas premium contributions (such as ERS, TRS or Texas A&M plans);
- Any dependent who is on active duty in the armed forces of any country, for coverage other than UT SELECT Medical.
Enrollment
There are three opportunities when employees may make insurance selections.
New Employee Initial Period of Eligibility
You have 31 days from your first day of employment to make your insurance coverage selections. If you're a full-time employee or graduate student academic employee, you're automatically enrolled in the Basic Coverage on the first day you're eligible for benefits. If you're a part-time employee (less than 40 hours per week), you won't automatically get the Basic Coverage. Instead, you must complete enrollment paperwork within your first 31 days or you will forfeit insurance coverage.
Review the New Employee Benefits Enrollment Checklist for details about how to complete your enrollment.
Change of Status Event
You can't change your insurance coverage during the year except in the case of a qualified change of status. You have 31 days from the date of a qualifying change of status event to notify the Human Resource Service Center and change your insurance selections. If you don't make your changes during the 31-day status-change period, your changes cannot be made until the next Annual Enrollment period in July, when Evidence of Insurability may be required.
Here are some common examples of qualified change of status events:
- Marriage, divorce, annulment, legal separation or spouse’s death
- Birth, adoption, medical child support order or dependent’s death
- Change in residence if the change affects your or your dependents’ current plan eligibility
- Starting or ending employment, starting or returning from unpaid leave of absence, or change of job status (e.g., changing from part-time to full-time)
- Change in dependent’s eligibility (e.g., marriage or reaching age 25 or age 26)
- Change in coverage or cost of other benefit plans available to you and your family
To make insurance changes, you will need to submit the following to the Human Resource Service Center during your 31-day period:
- Documentation of your change of status event, such as a marriage or birth certificate, court order or proof of gain or loss of non-UT insurance coverage
- Proof of relationship documents, if adding a dependent to your insurance coverage
- Insurance Enrollment/Change Application
- Dependent Information Form, if adding or dropping dependents
- Special Dependent Application, if adding an adopted child, grandchild, foster child or child for whom you have legal guardianship or conservatorship
- UT Flex Enrollment Form, if adding, changing or dropping a flexible spending account
Your insurance changes must be consistent with your change of status event. Evidence of Insurability may be required for some changes.
Annual Enrollment
Annual enrollment occurs in July. During this time, you may make changes to your insurance and add or remove dependents from coverage using the online enrollment system, My UT Benefits. In June, "Your UT Benefits Enrollment Options" notice is sent to each benefits-eligible employee via e-mail (or campus mail if you don't have an e-mail address on file). This notice lists your current coverage selections and options for the upcoming academic year. Choices you make during Annual Enrollment will start September 1 or later when your Evidence of Insurability is approved if that's required.
Information about benefits program changes is provided each year on the Annual Enrollment Web site.
Evidence of Insurability
Evidence of Insurability (EOI) is a record of a person’s past and current health events. It's used by insurance companies to verify whether a person meets the definition of good health.
Review the table below to determine when you or your dependents must submit an EOI form.
| Insurance Plan | New Employee Initial Period of Eligibility | Change of Status Event | Annual Enrollment |
|---|---|---|---|
| Medical | No | No | No |
| Dental | No | No | No |
| Vision | No | No | No |
| UT Flex | No | No | No |
| Term Life | If applying for coverage of 4x, 5x, or 6x salary for self or $25,000 or $50,000 for spouse | For any increase of coverage, except $10,000 dependent coverage* | For any increase of coverage, except $10,000 dependent coverage* |
| AD&D | No | No | No |
| Short-Term Disability | No | No | Yes |
| Long-Term Disability | No | No | Yes |
| Long-Term Care | Spouse or other family members only | Yes | Yes |
*You must have coverage of at least 1x salary in order to enroll your dependents for $10,000 coverage.
You must submit the EOI form as indicted by the deadline below, depending upon your enrollment opportunity.
| Enrollment Opportunity | EOI Form Submission | Deadline |
|---|---|---|
| New Employee Initial Period of Eligibility | Paper form submitted directly to insurance company | 31 days from your first date of employment |
| Change of Status Event | Paper form submitted directly to insurance company | 31 days from the date of your change of status event |
| Annual Enrollment | Online form completed in My UT Benefits enrollment system | Typically August 15, although insurance selections must be made by the end of Annual Enrollment, which is typically July 31 |
