Waiver of Insurance Coverage
If you have medical, vision and dental insurance provided from elsewhere, you may elect to waive Lawrence Tech's coverage. In lieu of this coverage, you will be paid opt-out cash. There are two plan options to opt-out of coverage as follows:
Plan 1 = Medical opt-out
Plan 2 = Medical, dental and vision opt-out
If you choose Plan 1, you opt out of medical insurance coverage only, however you may enroll in the dental and/or vision plans. If you choose Plan 2, you opt out of medical, dental and vision coverage. Both plan options are taxable benefits and subject to FICA, Federal, state and city taxes. The amount deducted for taxes depends on individual circumstances. Calculations will not be provided prior to actual payment.
Employees who terminate employment during the year will forteit any remaining waiver fee.
To enroll in either plan:
- Complete the Waiver of Insurance Coverage Certification of Other Insurance Form.
- Show proof of other insurance by providing a copy of an insurance I.D. card. Note: Canadian citizens covered by OHIP are also required to show proof of insurance.
- Submit both documents to the Office of Human Resources.
Special Enrollment Period
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires Lawrence Technological University to inform you of your right to Special Enrollment under any of the medical insurance plans offered by the University when you or your eligible dependents (spouse/children) decline coverage during the initial enrollment period.
· If you are declining enrollment for yourself, or your dependents (spouse/children) because of coverage under another plan, you may be able to enroll yourself or your dependents in the University plan in the future, provided you request enrollment within thirty (30) days after your other coverage ends.
· If you are declining enrollment for yourself, or your dependents (spouse/children) because of coverage under Medicare or Medicaid, you may be able to enroll yourself or your dependents in the University plan in the future, provided you request enrollment within sixty (60) days after your other coverage ends.
In order to qualify for this special enrollment period, you must certify other coverage was the reason for declining/waiving enrollment in coverage provided through LTU. You will need to complete and return the benefits election/enrollment forms to Human Resources within the deadlines indicated.
Questions? Email firstname.lastname@example.org
Lawrence Tech in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.
Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Office of Human Resources reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern. Lawrence Tech in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents.