180.110 – HEALTH INSURANCE (SECTION 105 & 125 PLAN)

Updated: January 2019

POLICY
It is organization policy that full-time (minimum 32 hours per week); year-round employees are eligible to participate in Maine Media’s health insurance plan. Maine Media provides coverage for the employee. Dependant (legally married spouse and/or legal children) coverage is available at a cost to the employee.

Temporary, seasonal and extended seasonal employees do not qualify for Maine Media’s health insurance, section 105 or 125 plans.

Health Insurance Opt Out
Maine Media’s health insurance eligible employees, who choose not to enroll in the company sponsored health insurance plan may receive a weekly stipend to help cover cost for a policy they may have elsewhere. Employee must be covered under another plan and provide proof of insurance to receive the stipend. The stipend applies only to the employee. Dependents DO NOT qualify for the opt out stipend. The stipend is considered income and will be taxed as such. Opt out stipend is only available to an employee during open enrollment period, a qualifying event, or a new hire.

Employees contracted to work at least 32 hours per week, and for more than six months of the calendar year are eligible for a partial (50%) health insurance benefit during their employment contract. The partial benefit is for the employee only. Any dependants will be at the 100% rate.

Health insurance starts the first day of the month following a 30 day waiting period from hire date. The employee’s contribution is deducted from the employee’s paycheck as a pre-tax deduction. If an employee’s contract is terminated, any outstanding monthly premium contribution will be deducted from the employee’s’ final paycheck.

To view the most current schedule of benefits, summary of benefits & coverage, insurance costs & enrollment form go to employee benefit website here: www.mainemedia.edu/employeebenefits

PROCEDURE
Section 105 Plan: Health Reimbursement Arrangement (HRA)
Maine Media is pleased to offer their employees a Health Reimbursement Arrangement. Employees participating in the organizations group medical insurance plan are automatically enrolled in the HRA Plan. This plan is designed to assist individuals with expenses covered under the organizations group health insurance plan, but subject to the deductible. This plan is administrator via a third party, Group Dynamics Inc.

The HRA Plan runs in correspondence with the policy plan year (January-December).

How claims are paid from the HRA:

  1. You receive medical care as you normally do. Your medical provider will file your claims with Harvard Pilgrim.
  2. Harvard Pilgrim will send GDI (Group Dynamic) an electronic report of deductible expenses on a regular basis. This data will go into their claims system. Claim payment is in the form of a check from Group Dynamic to you at your home address, or a direct deposit to your bank account. The payment from GDI will be based upon the application of the company’s HRA plan design to the actual claims sent to GDI by Harvard Pilgrim.

Should employment be terminated the employee may continue to receive the HRA benefit thru COBRA with a monthly administrative fee.

To view the most current benefit overview & summary of benefits go to employee benefit website here: www.mainemedia.edu/employeebenefits

Section 125 Plan: Flexible Spending Account (FSA) & Dependent Care FSA
As part of the organizations Section 125 plan, year-round employees working a minimum of 25 hours per week, are eligible to contribute to a Flexible Spending Account. The employee designates the amount of the pre-tax dollars ($500 min, $2,700 max) the employee would like withheld from the employees’ paycheck each week and deposited into a Flexible Spending Account (FSA). When the employee experiences qualifying medical or dependent care expenses, the employee can use the pre-tax money in the employees FSA to pay for or be reimbursed for those expenses.
To view the most current summary plan descriptions, eligible expenses & enrollment form go to employee benefit website here: www.mainemedia.edu/employeebenefits