102.3 - Health Insurance Continuation for EHRA Employees

University Group Policy #102.3

Policy Statement

In accordance with State law, Winston-Salem State University will continue paying premiums for employees whose job is eliminated due to a reduction in funds, unless otherwise exempted, for up to twelve (12) months of continued coverage under the State Health Plan if the employee meets the eligibility criteria for coverage to remain in effect (N.C.G.S. 135-40.2 et. seq.).

Guidelines

Elimination of an employee’s job neither requires nor permits an employer to pay State Health Plan premiums for dependents of the employee; however, the former employee may continue dependents’ coverage under the same terms as current employees. At the expiration of this coverage, former employees may pay the premiums for their continued coverage and that of their dependents. There is no time limit as to how long this coverage may be purchased.

  1. Winston-Salem State University will ensure that coverage is properly provided to former employees who meet the eligibility criteria below.
  2. The employee’s job must be eliminated. This policy does not apply to an employee’s separation from a job that does not result in the position being eliminated or abolished.
  3. The job elimination must be due to a reduction, in total or in part, of the funds used to support the job or its responsibilities. This includes a reallocation of funds and elimination of the position. The source of funds for the position does not affect eligibility for this benefit, except if the appointment is contingent upon the availability of funds. (See Ineligibility for Continued Coverage below.)
  4. Employment for at least twelve (12) months in a permanent full-time or permanent part-time (three/fourths time or more) position by WSSU, an affiliated entity, and/or another state entity (can be more than one), prior to the elimination of the job, is required.
  5. The employee must be participating in the State Health Plan at the time of separation from employment due to elimination of the job.

If any of the following conditions apply, the employee will not be eligible for continued coverage.

  1. An employee working pursuant to a fixed term contract that ends at the same time as the termination is not eligible for this coverage.
  2. An employee who was (a) paid in total or in part from non-state funding sources, and, (b) at the time of the job elimination was working under an appointment letter or a contract, either of which states that the job is contingent on the continuing availability of funds is not eligible for this coverage.
  3. An employee who retires (withdrawal from active service with a retirement allowance from the Teachers’ and State Employees’ Retirement System of North Carolina or the UNC Optional Retirement Program) is not eligible for this coverage. In this case, health insurance is provided through the retiree health insurance program.

Applicability

This policy applies to all Winston-Salem State University EHRA employees.

Compliance

Prior to communicating with the employee, a departmental representative must contact Human Resources to review the circumstances to determine if the proposed job elimination is due to a reduction in funds. If Human Resources determines that this Regulation applies; HR will work with the department to ensure that the employer-provided contributions to the employee’s State Health Plan coverage are appropriately continued for up to twelve (12) months. Additionally, the employing department must communicate in writing to the employee that he or she is being separated due to the unavailability of funds to support the position.


Responsible Division: Vice Chancellor and Chief of Staff

Authority: Board of Trustees

History:

  • June 17, 2011