What (& When) Is Enrollment?


Enrollment is when you sign up for (or update) your Waters benefits. And there are four different types of enrollment you might go through while you’re a Waters employee:

New Hire Enrollment

This is the time when new Waters employees — or existing employees who have just become eligible for benefits due to a change in their job status — enroll in benefits for the first time.

The enrollment window lasts 30 days, starting from:

  • A new hire’s first day of work
  • An existing employee’s first day as a benefits-eligible employee

During New Hire enrollment, you will have the option to enroll in any benefits.

You’ll automatically be enrolled in basic employee life and AD&D coverage policies, short-term disability and long-term disability coverage, and business travel protection services.

For most benefits, your coverage becomes effective your first day of work. This is true even though you might not actually go through enrollment until days after your start date. Some of the Voluntary Plans, like Colonial’s/Paul Revere’s Critical Illness Plan, will use an effective date of the day you complete your enrollment in the plan.

For Example

Hannah started at Waters on Monday, June 1st. A couple days later (on June 3rd), Hannah went to see her doctor. But she didn’t complete enrollment until her 15th day on the job. (Things were very busy in Hannah’s department.)

Once Hannah’s enrollment in a medical plan was complete, it retroactively went into effect from her first day on the job, and she was able to submit a claim for that June 3rd doctor visit to her new coverage provider. (The “effective date” of her new coverage was her start date, June 1st.)

If Hannah had also seen the doctor sometime in May, before her June 1st start date, that visit would NOT be covered by her new medical plan. (Which shouldn’t be that surprising, considering she didn’t even work at Waters yet.)

If you miss the New Hire deadline…and don’t complete enrollment in your benefits by the end of your first 30 days at Waters, you’ll automatically:

  • Be auto-enrolled in these plans, at no cost to you (they’re paid for by Waters):
    • Basic Short-Term and Long-Term Disability
    • Basic Life
    • Basic AD&D
    • Business Travel Accident Insurance
  • Be auto-enrolled in the Waters 401(k) retirement plan, at a contribution level of 3% of your salary (before taxes). Your contribution level will then automatically increase by 1% a year, until you reach 10% of your salary, but you can increase/decrease your contribution amount at any time during the year, at www.401k.com.
    • Waters matches up to 6% of your salary in contributions.
  • WAIVE all other plans.

Open Enrollment

Open Enrollment is the annual period when Waters employees get to renew or update all their benefits for the coming year.

Open Enrollment takes place in the fourth quarter of the year (usually specific dates in October and November). All benefit eligible employees participate in Open Enrollment; even if you are hired in the fall and complete your New Hire Enrollment before Open Enrollment, you’ll still be required to go through Open Enrollment afterward. Any new selections or changes you make at that time will go into effect on January 1st of the upcoming year, and remain in effect for the rest for the year.

If you miss the Open Enrollment deadline…there are no automatic re-enrollments for Flexible Spending Accounts (FSAs) or for Health Savings Accounts (HSAs). If you are currently enrolled in an FSA or HSA, but miss the Open Enrollment deadline, you will not be contributing to the account in the following year (although you can start or change your HSA contributions at any time after the first payroll).

FSAs include:

  • General Purpose Health FSA
  • Limited Purpose Health FSA
  • Dependent Care FSA

Aside from what is mentioned above, if you miss Open Enrollment, all of your plans will carry over into the new year. This isn’t always the case. Pay attention to the details communicated each Open Enrollment, because some years, many plans won’t automatically carry into the next year when there are significant changes to those plans.

But even if you think you just want to leave your benefits as they are, it’s a good idea to actively step through Open Enrollment. It’s a great time to review all of your benefit elections and make sure they’re still right for you. Once Open Enrollment ends, there’s no going back on most of your elections-unless you qualify for a Special Enrollment/Life Event. (It’s also a good time to review your beneficiaries, and make sure they’re still in line with your wishes.)

Special Enrollments/Life Events

What is a Life Event?

In most cases, the benefits you choose during enrollment can’t be changed for the rest of the year. However, when something happens in your life that significantly affects your coverage or coverage needs, you may be able to change some of your selections before then. These situations, known as life events, allow you to take part in a 30-day special enrollment period.

Life events generally fall into two categories:

  • Changes to the size of your household, like:
    • Getting married, divorced, etc.
    • New birth, adoption, etc.
  • Changes to coverage or coverage eligibility (that affect you, your spouse/partner, or your dependents), such as:
    • Taking (or returning from) approved, unpaid leave
    • A covered dependent turning 26, and no-longer qualifying for coverage on your medical plan
    • YOU turning 26, and losing access to a parent’s medical coverage
    • Your spouse/partner starting a new job, with benefits
    • Your spouse/partner leaving a job, and losing access to those benefits
    • You, your spouse, or your partner changing employment status in a way that affects benefits eligibility (such as switching from part time to full time, and thereby qualifying for
      new benefit plans)
    • Having a spouse or partner with an Open Enrollment window that doesn’t match with your Open Enrollment window at Waters
    • A significant change in the cost of your day care.
      • This doesn’t apply if your dependent care provider is a relative. (Aunt Nessie upping her hourly nanny rate by $1.50 doesn’t count as a life event.)
    • A change in Medicaid or Comprehensive Health Insurance Plan (CHIP) eligibility
      • Gaining/losing this type of coverage gives you 60 days to apply for enrollment changes to any affected coverage, instead of the 30 day rule that applies to other life events
    • Etc.

But these are just examples. In general, if something big has happened (or is going to happen) in your life that affects you coverage needs, it’s a good idea to see if you qualify for a special enrollment.

Now, life events don’t give you a blank check to change all your coverage, but you will be able to make changes that are consistent with your event.

For Example

When Hannah had a baby girl, after a few long days (and nights), she logged onto WatersBenefitsNow.com and declared the birth event. She then went through and chose the benefits they needed at this time, like medical insurance. They know babies don’t get teeth for several months, so there was no need to add her to Michele’s dental and pay the extra premium at this time, and there is always next year’s open enrollment.

To get started with (or declare) your life event, enter your information at www.watersbenefitsnow.com. You’ll have to declare the event and complete your Special Enrollment no more than 30 days after the event occurs. For some life events, you must provide verification of the event.

If you miss the Special Enrollment deadline…you won’t get to make any changes to your benefits for this life event. Missing the deadline means you will have to wait for the next Open Enrollment to make adjustments. All elections made during your Life Event 30 day window will have an effective date retro back to the Life Event’s effective date. The exception to this rule would be some of the Voluntary Programs, like Colonial’s/Paul Revere’s Critical Illness Plan, which will use an effective date of the day you complete your enrollment in this plan. Your effective date will be shown to you once you are making your election.

Learn more about special enrollments and other types of life events at www.watersbenefitsnow.com, or speak to your Waters Benefits Now representative at 1-866-994-5111.

Rehires

If you leave and are then rehired by Waters more than 30 days after your term date, you’ll have to follow the New Hire Enrollment process.

However, if you leave and are rehired by Waters within 30 days of your benefits end date, your coverage will be reinstated at the same level it was when you left the company. Keep in mind though, that adjustments may be made to some plans (like contributions to flexible spending accounts), to reflect your time away from Waters.

For Example

Less than a month after Jun left his job at Waters to help his brother run his software company, the business went under.

Fortunately, that meant when Jun was hired back by Waters, he had been away for less than 30 days and his previous benefits elections (including his medical plan and the Limited Purpose Health FSA) were restored to what they had been before he left.

To make up for his month away though, Jun increased his per-paycheck FSA contributions so he could still get the maximum tax advantage.

If Jun had been away longer than 30 days, he may still have been hired back, but he’d have to re-enroll in his benefits as a New Hire. He’d also lose dibs on the best coffee mug.

If, during the time you’ve left and returned to Waters, you’ve had a life event that would qualify you for a Special Enrollment, contact the Waters Benefits Now Call Center at 1-866-994-5111.

For Example

While Jun was away from Waters, he turned 26 years old, which meant he was no longer eligible to receive vision and dental coverage from his parents. But Jun was fortunate again, as becoming ineligible for your parents’ coverage is a life event. So he was able to qualify for a Special Enrollment and sign up for vision and dental coverage through Waters.

If he hadn’t had a life event, he would not have been allowed to change his elections.

Exceptions to Enrollment Windows

Not all changes to your benefits elections need to be made during the enrollment windows mentioned above.

  • If you enroll in a Waters medical plan, you can start, stop, or change your contributions to your Health Savings Account at any time on WatersbenefitsNow.com.
  • If you participate in the Retiree Health Care Reimbursement Plan, you can stop your contributions to this plan at any time. (Though you can’t restart them outside of Open Enrollment.)
  • If you turn 50 during the year, within 30 days following your birth date you can newly enroll in the Retiree Health Care Reimbursement Plan (see the “Make Changes” section on the web site).
  • You may enroll in the 401(k), or adjust your contributions to the account, at any time during the year. Visit 401k.com.
  • You can change your designated beneficiaries for all plans at any time.
  • You can also enroll in, or make changes to your Pet Insurance or Auto/Home Insurance at any time during the year by contacting 1-855-874-4944 Nationwide. For Pet Insurance and for Auto/Home Insurance through Farmers: if in New England, contact Tammy Weaver at 1-508-372-9634, or everywhere else at 1-800-438-6368.

Who Is Eligible for Benefits?


To be eligible for Waters benefits, you first have to be either a Waters employee or the dependent of a Waters employee. (Remember that dependents aren’t just children! When you’re talking about benefits, dependents include spouses and partners. See the full list of dependents below.)

Now, assuming you are a Waters employee (or the dependent of one), here are some specific requirements for benefit eligibility.

Employee Eligibility

To qualify for benefits as a Waters employee, you need to be:

  • A regular, full-time employee who works at least 37.5 hours a week
  • A regular, part-time employee who works at least 20 hours a week

(Exception: Any Waters employee is eligible to participate in the 401(k) Plan, regardless of work hours.)

And, just to be clear, you are NOT eligible to receive Waters benefits as an employee if you are:

  • A contractor
  • An intern
  • A seasonal/temporary worker
  • A part-time employee who works fewer than 20 hours per week

Dependent Eligibility

If you, as a Waters employee, are eligible for benefits, then eligible dependents include your:

  • Legal spouse, including same-sex spouses and common-law spouses
  • Domestic partner (same or opposite sex)*. (If you weren’t aware, this is more than just living together. See the Domestic Partner Eligibility Requirements and tax implications at WatersBenefitsNow.com for details.)
  • Divorced or legally separated spouse until either of you remarries, if a legal judgment or court order requires this coverage.There are exceptions though to exactly which plans they are eligible for. Your divorced or legally separated spouse is not eligible for spouse life insurance or family AD&D, nor are their health care expenses eligible under the Health Care Flexible Spending Account or Health Savings Account.(Note that, if either of you remarries, or a court order exists that requires you to continue to cover your ex-spouse under your employer’s health plan, please contact Waters Benefits Now at 1-866-994-5111 for options.)
  • Dependent child under age 26*, including:
    • Foster children
    • Adopted children
    • Children of your covered spouse, covered civil union partner, or covered domestic partner
    • Children of your child (aka your grandchildren), if your child is an eligible, covered dependent on your plan
  • Unmarried child of any age who is mentally or physically incapable of self-care*. (You may need to confirm your child’s eligibility by providing medical or other information.)

A few FYI’s to keep in mind when it comes to covering dependents:

  • If your spouse/partner or child dependent are also a benefits-eligible Waters employee, they cannot be a covered dependent of yours for Spouse or Child Life Insurance, since they already will have their own Life Insurance through Waters.
  • If you enroll a child who cannot be claimed as a dependent on your taxes, Waters or the health plan may also request some supporting documentation to confirm their relationship to you.
  • Certain benefits, such as pretax HSA Accounts, can’t be used to pay for out-of-pocket expenses for dependents who aren’t your tax dependents. (For assistance, call the Waters Benefits Now Call Center at 1-866-994-5111.)
  • For most basic plans, Waters pays the majority of the premium costs for your plan. In most situations, the money Waters spends on your behalf is untaxed by the federal government. However, if you cover a domestic partner, civil union spouse, or their eligible dependents, the IRS considers Waters’ share of those costs to be taxable income.

For Example

When Hannah signed up for her benefits, she opted to cover her domestic partner, Michelle. Adding Michelle to the plan increased the total premium cost – not just for Hannah, but also for Waters. (Not to mention, unlike Hannah’s regular premium, the extra portion covering Michelle comes out of Hannah’s paycheck AFTER taxes; it’s post-tax.) Remember, Waters pays about 85% of the medical premium costs, on average. The premium cost you are responsible for–the one you see listed by a plan–is what’s left after Waters has paid its share.

When it comes time to calculate taxes, the IRS will take that extra amount Waters paid for insuring Michelle, and add that number to Hannah’s income. That total will be the amount the IRS uses for calculating how much tax Hannah owes. So if Hannah makes $50,000 this year, and Waters has to pay an extra $5000 to cover Michelle that year, the IRS will tax Hannah as though she made $55,000.

 


Now, if you have someone you want to cover who isn’t on that list above, chances are they aren’t eligible. Here’s a list of family and personal relations people sometimes want to cover, but who don’t qualify as dependents:

  • Boyfriend/Girlfriend or fiancée/fiancé who does not meet Waters’ Domestic Partner Eligibility Requirements and Tax Notice as featured at WatersBenefitsNow.com.
  • Parents
  • Grandparents/Other Relatives
  • Brothers/Sisters

Of course, special rules may apply for certain situations. For instance, when there’s a court order addressing medical coverage, a former spouse, adopted dependent children, legal guardianship of dependent children, or when a family member has a different last name than you.

It probably goes without saying that enrolling someone who is not qualified as a dependent is considered insurance fraud. No one expects you would do something like this. However, if you were to take part in this kind of fraud, possible consequences could include severe corrective action-up to and including:

  • Termination of employment
  • Repayment of premium costs for non-qualified persons
  • Cancellation of coverage and repayment of costs for services, back to the date they were first enrolled
  • Permanent prohibition from enrolling in any benefit plan at Waters, or anywhere else.

If you’re not sure someone you want to cover qualifies as a dependent, please contact the Waters Benefits Now Call Center at 1-866-994-5111.