Insurance Eligibility of Graduate Student Fellows

SB-29, Insurance Eligibility of Graduate Fellows was passed in the 2011 legislative session and signed by the Texas governor. Sponsored by Senator Judith Zaffirini, Chair of the Senate Higher Education Committee and Representative Dan Branch, Chairman of the House Committee on Higher Education, the bill will allow graduate students receiving certain fellowships of $10,000 or more per year to be eligible to participate in UT's group medical insurance plan (i.e., basic medical for the fellow and dependents, including dental and vision insurance). Please note that there is no funding provided to pay the medical premium for the fellow. The bill just provides access to the group medical benefits plan.

The following should answer most of your questions:

When does the graduate student fellow become eligible for accessing the group health insurance plan?
9/1/11 is the effective date. The bill refers to the act taking effect January 1, 2012, but UT System Office of Employee Benefits has confirmed that there is a provision for early implementation within the bill, which UT System has opted to follow.

Which students are eligible? What documentation is required?
Students must hold in aggregate a “competitive” award or awards of $10,000 or more per year. For fellowships not administered by UT, the fellow will need to present evidence of an award showing the amount and dates of the award to the Human Resources Service Center (HRSC). The funding and dates on the fellowship document should fall within the fiscal year during which the fellow is eligible to purchase the health insurance.

Fellows who receive sufficient funding to qualify during the 2011-12 fiscal year should be eligible for the benefit no matter when their fellowships first began. What is most relevant is the $10,000 annual qualifying amount, and that the fellow be receiving a stipend from the fellowship for the months that he/she is eligible.

Is a student eligible for the group insurance plan if the student has a fellowship that pays a stipend of less than $10,000 per year, but the student also has a separate tuition payment credit, and the total of the stipend plus paid tuition is $10,000 or more?
No - the stipend paid to the student has to be $10,000 or more per year.

Is a student eligible for the group insurance plan if the student has a one-semester or summer-only fellowship that pays a stipend of at least $1000 per month during the months they are on the award (i.e., the monthly rate is high, but the total amount of the award is below $10,000)?
No - the stipend has to be $10,000 or more per year.

Is a student eligible for the group insurance plan if the student had a one-semester award for $5000 for the fall, but subsequently picked up a second award for at least $5000 for the spring?
Yes - the student could enroll in the group plan starting in spring once they have qualified on the basis of having a total stipend of $10,000 or more per year.

Is a student eligible for the group insurance plan for the full year if the student has an award stipend of at least $10,000 for the year, but it is paid to the student in one lump sum at the beginning of the year?
Yes - as long as the stipend is $10,000 or more per year, and it is obvious from the award letter that the award is for the full year period.

What will it cost for a student to enroll?
See the HRS web page for costs and additional benefit information.

When can eligible fellows enroll? Are they limited to the summer open enrollment period?
Individuals eligible for the insurance have three enrollment/change opportunities: the initial enrollment period, Annual Enrollment, and any mid-year change of status events.

• The initial enrollment period is a 31-day period that would begin with the start date of the fellowship.
• Annual Enrollment is the open enrollment period during July when anyone can make changes for any reason.
• A mid-year change of status event would include events such as a marriage, birth, or loss or gain of other insurance coverage that would allow the individual to make applicable insurance changes within 31 days of the event (or even enroll for the first time if they didn’t previously).

See the HRS web page for additional information.

Could a fellow enroll for the insurance in January or at some other time if he/she were eligible in September but chose not to enroll?
No – not without a mid-year change of status event (see above).

What list of insurance coverage options are fellows eligible for?
Eligible students may enroll in the plans below:

• Medical (including $20,000 term life and $20,000 accidental death and dismemberment insurance for the student only)
• Dental
• Vision

Eligible students may also enroll their eligible dependents in the medical, dental or vision plans. Students are not eligible for any other plans offered to employees as part of the university's group insurance program or the university's retirement programs. see the HRS web page for additional information.

How would a student sign up for the program? Where do they go to sign up? Graduate School, Department, HRSC – does it differ by source of funds?
All eligible students would sign up through HRSC. see the HRS web page for additional information.

How will the premiums be paid?
Fellows are responsible for paying the premiums. The university is unable to pay for these, and it is not possible to charge them directly to a university account. Programs have the option to increase stipends to enable students to receive more funds from which they may pay the premiums directly if they so choose. It is not possible to deduct the premium amounts from payments the fellow receives, but payment options will be communicated upon enrollment in the plan. see the HRS web page for additional information.

What about tax advantages (a $25K fellowship vs. a $20K fellowship and $5K for medical premiums)?
None – all funds paid will be viewed as part of the stipend on the fellowship.

Will the Graduate School be able to increase the size of the fellowship this fall to cover the amount needed for the group health insurance?
No – all our fellowship funds were committed in the spring for AY2011-2012. We will consider how to reconfigure future fellowships. However, the Graduate School contributes $1204 (the equivalent of student health insurance) in the fall for many fellowship holders, which the graduate student fellows may use toward paying for medical premiums if they opt to sign up for the group plan.