Frequently Asked Questions regarding Insurance Eligibility for ...

According to Section 1601.1021 of the Texas Insurance Code, postdoctoral fellows and
graduate student fellows who meet the following criteria are eligible to participate in
the Texas A&M University System insurance programs (i.e., medical, dental and vision
insurance plans for the fellow and their eligible dependents).
? Postdoctoral fellowships, or
? One or more graduate student fellowships awarded to the individual on a
competitive basis that, either singly or in combination, are valued at not less
than $10,000 per year, and
? Is currently receiving a stipend from an applicable fellowship.

PLEASE NOTE: The fellow must pay the full premium cost for the insurance
coverage. This process pertains to Postdoctoral Fellows or Graduate Student
Fellows who are NOT employees and NOT currently paid as employees through
Texas A&M University or other System Payroll Office. Graduate Assistants
(GATs, GANTs, GARs, and GALs) are employees of Texas A&M University and
continue to be eligible for the insurance programs.

When does the postdoctoral or graduate student fellow become eligible for
accessing the group health insurance plan?
Beginning September 1, 2012, fellows who meet the above guidelines are eligible to
enroll in the group medical insurance plan following the procedures established for
Postdoctoral and Graduate Student Fellows.

Which fellows are eligible? What documentation is required?
Fellows must hold in aggregate a ?competitive? award or awards of $10,000 or more per
year and receive a stipend from an applicable fellowship. Department Heads, the Office
of Graduate Studies, or the Office of the Vice President for Research must certify that
an individual meets the criteria above. The Postdoctoral Fellows or Graduate Student
Fellows Certification form (insert link to the form) will be sent to Human Resources (HR).
Upon receipt, individuals who meet the criteria will receive notification from HR regarding
insurance options and instructions for enrollment.

Is a student eligible for the group insurance plan if the student has a fellowship
that pays a stipend of less than $10,000 per year, but the student also has a
separate tuition payment credit, and the total of the stipend plus paid tuition is
$10,000 or more?
No ? the stipend paid to the student has to be $10,000 or more per year.

Is a fellow eligible for the group insurance plan if the fellow has a one-semester or
summer-only fellowship that pays a stipend of at least $1000 per month during the
months they are on the award (i.e., the monthly rate is high, but the total amount
of the award is below $10,000)?
No ? the stipend has to be $10,000 or more per year.

Is a fellow eligible for the group insurance plan if the fellow had a one-semester
award for $5000 for the fall, but subsequently picked up a second award for at
least $5000 for the spring?
Yes ? the fellow could enroll in the group plan starting in spring once they have qualified
on the basis of having a total stipend of $10,000 or more per year.

Is a fellow eligible for the group insurance plan for the full year if the fellow has an
award stipend of at least $10,000 for the year, but it is paid to the student in one
lump sum at the beginning of the year?
Yes ? as long as the stipend is $10,000 or more per year, and it is obvious from the
award letter that the award is for the full year period.

What will it cost for a student to enroll?
Go to the benefits section of the HR web page for premium costs and additional benefit
information. www.employees.tamu.edu

When can eligible fellows enroll? Are they limited to the summer open enrollment
period?
Fellows eligible for the insurance have three enrollment/change opportunities: the initial
enrollment period, Annual Enrollment, drop coverage, and any mid-year qualified change
of status events.

?The initial enrollment period is a 60-day window. The 60 days will begin on the
date that Human Resources notifies the fellow or the start date of the fellowship,
whichever is later.
?Annual Enrollment is the open enrollment period during July when changes can
be made for any reason.
?A fellow has the option to drop coverage at any time and may re-enroll only
during the following Annual Enrollment period held in July.
?A mid-year qualified change of status event allows individuals to make certain
applicable and appropriate changes to the benefit selections. Examples of
qualified changes of status include events such as a marriage, birth, or loss or
gain of other group insurance coverage that would allow the individual to make
applicable insurance changes within 60 days of the event (or even enroll for the
first time if they didn?t previously). Individuals experiencing a qualified change
of status should contact HR to determine enrollment or benefits change options
applicable to their type of change in status.

Go to the benefits section of the HR web page for premium costs and additional benefit
information. www.employees.tamu.edu

Could a fellow enroll for the insurance in January or at some other time if he/she
were eligible in September but chose not to enroll?
No ? not without a mid-year qualified change of status event (see above).

What list of insurance coverage options are fellows eligible for?
Eligible fellows may enroll in the following plans:
?Medical
?Dental
?Vision
Eligible fellows may also enroll their eligible dependents in the medical, dental or vision
plans. Fellows are not eligible for any other plans offered to employees as part of the
university?s group insurance program or the university?s retirement programs.
Go to the benefits section of the HR web page for additional information.
www.employees.tamu.edu.

How would a fellow enroll in the program? Where do they go to enroll?
All eligible fellows may enroll through HR. Contact 862-1718 or benefits@tamu.edu for
additional information regarding the enrollment process.

How will the premiums be paid?
Fellows are responsible for paying the full premiums. Upon enrollment fellows will
complete bank draft information for the premiums to be paid automatically each month.
Programs have the option to increase stipends to enable students to receive more funds
from which they may pay the premiums directly if they so choose. It is not possible to
deduct the premium amounts from payments the fellow receives through their student
account.

Will the Graduate School be able to increase the size of the fellowship this fall to
cover the amount needed for the medical premiums?
No ? all our fellowship funds were committed in the spring for FY2012-2013. We will
consider how to reconfigure future fellowships. However, the Graduate School makes
available a reimbursement for approximately $1200 (the equivalent of student health
insurance) in the fall for many fellowship holders, which the graduate student fellows
may use toward paying for medical premiums if they opt to sign up for the group plan.

Source: http://ogs.tamu.edu/2012/08/faqs-insurance-eligibility-for-postdoctoral-and-graduate-student-fellows/

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