The Benefits Plan Year runs from January 1 through December 31.
Employee Eligibility
Regular full-time or part-time employees (excluding interns, temporary and variable hour employees) who are scheduled to work 30 hours or more per week are eligible for the benefits described on this site. Coverage begins the first of the month following your hire date. If you are hired on the first of the month, your coverage begins on your hire date.
Dependent Eligibility
As you become eligible for benefits, so do your eligible dependents. In general, eligible dependents include:
- Same or opposite sex spouse, including a common law spouse
- Same and opposite sex domestic partner
- Your children, including biological children, stepchildren, adopted children, children placed for adoption and children you are legally obligated to support. The limiting age for children is 26, except there is no limiting age for children who are dependent on you as the result of a physical or mental handicap.
Domestic Partner Coverage
The IRS considers health coverage for a domestic partner a taxable fringe benefit that must be included in an employee’s gross income. Therefore, the portion of premiums that Inovalon pays on behalf of your domestic partner for health, dental and vision insurance must be taxed. This process is referred to as “imputed income.” Also, any medical, dental and vision plan payroll contributions that you pay that are attributable to your domestic partner’s coverage must be taxed. This means a portion of your payroll contributions will be deducted after taxes are deducted.
Health and Welfare Deductions
Your health and welfare benefits deductions will be taken each pay date that your coverage is effective. Generally, your benefits deductions will begin within one to two paychecks following your enrollment. If you are a new hire and (1) you receive a paycheck with no benefits deductions, and (2) your benefits deductions were effective as of that pay date, retroactive benefits deductions will be taken from your next available pay. For example:
- Jacob is hired on April 26. He receives his first paycheck on May 14. Jacob enrolls in benefits on May 17. His benefits coverage effective date is May 1.
- Even though Jacob’s benefits coverage was effective May 1, he had no health and welfare benefits deductions taken from the May 14 paycheck as he enrolled in coverage after he received his first paycheck.
- On the May 28 paycheck, he will have double health and welfare benefits deductions taken – his regular benefits deductions for the May 28 paycheck and the deductions that should have been taken from the May 14 paycheck.
- If Jacob had enrolled in benefits on April 27, benefits deductions would have been taken from the May 17 paycheck. No double deductions would be taken on the May 28 paycheck.
Emily is hired on May 10. She enrolls in benefits on May 12. Her benefits coverage is effective on June 1. Emily receives her first paycheck on May 28.
- No benefits deductions are withheld on the May 28 paycheck. She will not owe benefits deductions for her May 28 paycheck as her benefits were not effective on May 28. They are effective June 1.
- Emily’s health and welfare benefits deductions will first begin on her June 11 paycheck.
401(k) Deductions
Your 401(k) contributions and the corresponding employer match will begin within one to two pay dates following your enrollment. IRS prohibits any contributions from being taken retroactively.
The health and welfare elections you make are for the entire calendar year and generally cannot be changed outside of annual Open Enrollment. However, if you have a Qualified Life Event as defined by the IRS, you will be able to make benefit changes that are consistent with your life event.
Qualifying Life Events
- Marriage, divorce or newly eligible same or opposite sex domestic partner
- Birth or adoption of a child
- Death of your spouse, domestic partner or dependent child
- Your spouse or domestic partner gaining or losing coverage at his/her job
- Reduction or increase in hours of employment by you or your spouse, domestic partner or dependent
- An event that causes a spouse, domestic partner or dependent to lose or gain eligibility
- A Qualified Medical Child Support Order
- Entitlement to Medicare or Medicaid
Benefit changes must be consistent with your event. For example, if you have a baby, you may add the baby to your medical coverage. You cannot, however, drop dental coverage for other family members at this time. You have 31 days within the event to change your benefit elections.
To request a change, log into the benefits website at enroll.apbenefitadvisors.com or call the Inovalon Employee Benefits Line at 888.896.8031.