Eligibility
Employer groups must have two or more full-time
employees enrolled.
Benefit Selections
Benefits are selected by the group and not the employee. For
Example: Orthodontia benefits are available to all employees of the group and cannot be
individually selected.
Contribution/Participation
The Employer must contribute a minimum of 50% of the employee premium.
75% of the eligible employees must participate, 100% must participate if the employer contribution
is 100% of the employee premium. Employees covered by a spouse's group plan
do not have to participate.
Employees
All employees of the employer who are performing active work on a
full time basis (20 hours a week or over) are eligible for benefits including corporate
officers, owners, or partners.
Dependents
All eligible dependents can enroll on the
original effective date.
Dependents can also be added for a
later effective date if they are newly eligible or as part of an open enrollment
process.
Eligible dependents include legal spouse
or domestic partner and children to age 26.
The employer is responsible to report any changes to a
dependents eligibility to Wolfpack Insurance Services, Inc.
Newborn children do not need to enroll until just before the first
appointment, usually before age 4.
Domestic partners
are defined as same-sex and opposite-sex
couples registered with any government agency authorizing such registrations.
Your domestic partner is subject to the same terms and conditions as any other
Dependent enrolled in this plan.
Open
Enrollment
Any employee who waived off the plan at
initial enrollment may elect coverage on the anniversary date of the groups
enrollment. We can also set the Open Enrollment date to be the same as the
renewal date (see below) or the Open Enrollment date of the group health plan.
Please contact us if you wish to make this change.
Any dependent who did not elect coverage when the plan was established may elect
coverage on the Open Enrollment date.
If an employee who had coverage through their spouse looses that coverage, they may be added the first
of the month after the loss of the other coverage.
Effective date
When a firm joins the Plan, the coverage of its current employees
will be effective on the first day of the month following approval of the firms
application to participate. Additions to your plan will be effective the first of
the month after the elected probationary period from their date of hire.
We have two renewal periods:
Groups that enroll from January 1st through June 1st renew
on January 1st.
Groups that enroll from July 1st through December 1st renew
on July 1st.
Retroactive Member Termination
Member terminations must be
received by the 14th of the month to be terminated retroactive to
the first of the previous month.
Group
Termination
Group termination information must be
received by the 14th of the month to be terminated retroactive to
the first of the current month.
Cal-COBRA & Federal COBRA
Cal-COBRA groups will give us the
members address upon termination of coverage and we will generate the Cal-COBRA
election form and invoice the member directly for the coverage.
Federal COBRA
groups will need to issue a COBRA form upon the qualifying
event.
Please follow this link to view and download model notices
provided by the Department of Labor.
COBRA Continuation Coverage | U.S. Department of Labor (dol.gov)
When the member elects COBRA, pease use the
Add Employee and/or Dependents to the plan form to re-add
the member on to your plan. Members who extend coverage under Federal COBRA will be invoiced with the
group and the individual premium collection is done by the group.
Please follow this link for a definition of Federal COBRA vs. Cal-COBRA and
to notify us which COBRA regulations apply to your group.
|