Eligibility & Dependents
“Aligned with our LSS Core Values, the Employee Benefits at LSS are designed to support the recruitment and retention of the talented individuals we need to live out our mission of “Older Adults Living Life to the Fullest”… Talented individuals like YOU. ”
Eligibility: Employees
There are various factors that determine which benefits in the overall LSS Benefits Program you are eligible for… Your employment status (e.g. Full-time, Part-time, PRN, etc.), your length of employment, and/or your number of actual worked/paid hours. Considering your just employment status, here are the benefits you may be eligible for:
All LSS Employees:
-Wellness Program
-Retirement benefits
-Employee Assistance Program (EAP)
-Telemedicine
-Leaves of Absence
-Pay Advances
-Commuter Benefits
-Some Educational Financial Assistance benefits
-Workers’ Compensation
-Discounts for External Products/Services
Part-time & Full-Time Employees:
-All of the benefits listed above, plus…
-Time Off Benefits
-Christ Care Fund
Full-Time Employees (including ACA-Eligible Variable Hour Employees):
-All of the benefits listed above, plus…
-Medical insurance
-Insurance Alternative Compensation
-Dental insurance
-Vision insurance
-Flexible Spending Accounts (FSA)
-Life insurance
-Disability insurance
-Voluntary Income Protection benefits
-All Educational Financial Assistance Benefits
Please review the additional sections that follow for more details related to eligibility, dependents, important dates for enrolling and coverage, etc. For additional information, please refer to the LSS HR policy – “Benefits & Insurance Eligibility” (LSS-HR-14) on LSSLink in the HR Policies section.
Below are definitions of the various employment statuses and employee groups within LSS, as it relates to benefits-eligibility:
A full-time employee is someone budgeted for 30 or more hours per week.
A weekend option employee is someone budgeted to work 32 hours per week but is generally paid for 40 hours per week.
A part-time employee is someone budgeted for anywhere between 1 and 29 hours per week.
A variable hour employee is anyone not in a Full-time or Weekend Option status (i.e. Part-time, PRN &/or Casual*), according to the ACA regulations *
An ACA-eligible variable hour employee is a variable hour employee who averaged 30 or more paid hours per week during their prior “Measurement Period” *
Chaplains eligible to participate in the Concordia Plan Services benefits must be rostered with the Lutheran Missouri Synod and budgeted to work at least 20 hours per week
*Some definitions of ACA terms include:
ACA: “Affordable Care Act”, sometimes referred to as “Healthcare Reform”
Initial Measurement Period (New Hire): LSS will look back over a one-year period (starting on the date of hire or rehire) to determine whether or not a variable hour employee’s paid hours averaged 30+ hours per week.
Ongoing Measurement Period: Once an employee completes his or her Initial Measurement Period, they become a part of the Ongoing Measurement Period, which is October 5 of the previous year through October 4 of the current year. This time period is used to determine if the employee averaged 30+ paid hours per week.
Initial Administrative Period: This period allows LSS time to calculate eligibility and identify benefit-eligible employees.
Ongoing Administrative Period: This time period runs concurrent with annual enrollment and accommodates a larger volume of enrollments and changes. This period allows LSS time to calculate eligibility and identify benefit-eligible employees.
Initial Stability Period: The LSS initial stability period is 12 months and begins on the day after the initial administrative period ends. Eligible variable hour employees who choose to enroll may remain on the benefit plans through the end of their stability period.
Ongoing Stability Period: The LSS ongoing stability period is a 12-month time period beginning on January 1 and ending on December 31. Eligible variable hour employees who choose to enroll may remain on the benefit plans through the end of the stability period.
Eligibility: Dependents
Eligible employees may choose to cover dependents on applicable benefit plans such as our LSS medical insurance, dental insurance, vision insurance, life insurance and voluntary income-protection benefits.
Eligible dependents include:
A spouse as recognized under the laws of the state where the employee lives.
Children, including natural children, stepchildren, legally adopted children, children covered under a “Qualified Medical Child Support Order”, and children for whom the subscriber or the subscriber’s spouse is a legal guardian.
Children may be covered through the end of the month in which they attain the age of 26. They may retain coverage beyond 26 years if the dependent is already enrolled, unmarried, and unable to support him- or herself due to physical or mental disability.
Eligible employees may elect varying coverage levels for different benefit plans. For example, an employee may prefer to elect “employee + children” for medical, “employee + spouse” for dental, and “employee only” for vision, or any other combination of the employee’s choosing.
When enrolling dependents into an LSS medical plan, the employee must provide documentation verifying that those dependents qualify to be covered. For more information on what documentation must be provided, please refer to the “Documentation required for verifying dependent eligibility” document below.
Resources:
Steps to take when an employee passes away
Steps to take when an employee’s dependent passes away
Documentation required for verifying dependent eligibility
Anthem Blue Cross Blue Shield Application for Continuation of Coverage for a Disabled Dependent