Initial Eligibility
Once an active member works at least 450 hours in a six-consecutive month period, he or she is eligible for insurance benefits on the first day of the following month. For example, if you worked 450 hours or more in the months of April, May, and June; you would generally become eligible for insurance benefits starting in July. Your contractor must report and pay the contributions due before you will become eligible. There is a one-month lag in contractors reporting working hours. This lag in reporting will result in a delay of you being notified of your eligibility. For more information on eligibility, review pages 17-43 in the Insurance SPD.
The reporting lag results in your eligibility being established retroactively. If you or any of your eligible dependents have any insurance claims after your eligibility date, but you are not notified of your eligibility, you can have the claims resubmitted for processing and payment.