Butler Health Plan

Initial (New Hire) Enrollment
- You are eligible to enroll in the Plan if you work for a participating school employer and you are a member of a group of employees designated by your participating employer as eligible to participate.
  
  To enroll in the Plan, you must return a completed BHP Enrollment/Change Form to your Treasurer or Personnel Department within 31 calendar days after your hire date. Your employer requires newly hired employees to provide the completed forms EVEN IF YOU DO NOT WANT TO PARTICIPATE. If you want to enroll in the Medical Plan, elect medical coverage and select the level of coverage; Employee, Employee +1 or Family.
Spouse's Enrollment
- In order to be eligible for coverage under the BHP Medical Plan, any spouse of an eligible employee who has coverage available through an employer-sponsored group health plan or retiree plan must join that plan on at least a SINGLE enrollment basis. If you enroll your spouse as a dependent, you must also complete the BHP COB Questionnaire unless your spouse is already enrolled in his/her employer's medical plan. BHP will coordinate benefits with your spouse's employer-sponsored group health plan.
Annual Open Enrollment
- Each year you have the opportunity to participate in the Medical Plan for the first time, change plan options, or add dependents without a qualifying event. You must return a completed BHP Enrollment/Change Form to your Treasurer or Personnel Department to enroll or make a change. If you are adding a spouse, see Spouse's Enrollment. Open Enrollment occurs in the Fall of each year with coverage effective January 1 of the following year.

Family Status Changes, Qualifying Events, District Enrollment Contacts

When family status changes occur, the last thing on your mind is to update your employer of these changes. However, failure to notify your employer may cause your medical claim payments to be delayed or denied. Also, your rights to enroll in the plan or continue coverage may expire. Notify your Treasurer or Personnel Department on an Enrollment/Change form of the following changes within 31 days of the qualifying event:
- Loss of medical or dental coverage due to:

Divorce
Death
Spouse’s coverage ends with employer due to termination or reduction of hours
COBRA exhausted

- Marriage
- Adoption
- Qualified Medical Child Support Order
- Child turns 19 in dental plan, not a full-time student
- Child turns 26 in medical plan
- Child gets married
- Address or phone number change

Special Provision: Newborns are covered at the moment of birth ONLY if you enroll your new baby in our Plan within the 60 days immediately following birth.

Your medical claim payments may be delayed or denied if you do not notify your Treasurer or Personnel Department.

Department Contacts
BCESC /Head Start	Patty Spath-Meyer	spathp@bcesc.org	887-5512
Butler Tech	Candi Fyffe	fyffec@butlertech.org	868-1911 x4138
BCBDD	Barb Schlichter	baschlichter@butlerdd.org	867-5962 x24
Fairfield	Sue Hollingsworth	hollingsworth_s@fairfield-city.k12.oh.us	858-7114
Fairfield	Sharon Revel	revel_s@fairfield-city.k12.oh.us	858-7111
Great Oaks	Paula Losey	loseyp@greatoaks.com	612-3615
Hamilton	Jodi Mishos	habo_jm@swoca.net	868-4422
Hamilton	Steve Patterson	steve-patterson@fc.hamilton-city.k12.oh.us	868-4453
Lakota	Lisa Manning	lisa.manning@lakotaonline.com	644-1180 x2
Lakota	Mary Jones	mary.jones@lakotaonline.com	644-1180 x2
Madison	Brian Rabe	brian.rabe@madisonmohawks.org	513-420-4756
Middletown	Mary Rose Farmer	mrfarmer@middletowncityschools.com	513-217-2650
Monroe	Rita Tannreuther	rtannreuther@monroelocalschools.com	539-2536 x7305
New Miami	Debbie Turner	nmbo_dt@swoca.net	863-0833 x3005
Ross	Brenda Olinger	robo_bo@swoca.net	863-1250
Sycamore	Carla Clark	clarkc@sycamoreschools.org	686-1700 x5002
Talawanda	Holly Turner	turnerh@talawanda.org	273-3100 x7

Continuation of Coverage - Consolidated Omnibus Budget Reconciliation Act (COBRA)
- COBRA is a federal law which requires each group health plan to allow employees and eligible dependents to continue their group coverage for a stated period of time following a qualifying event that causes the loss of group health coverage. COBRA allows you or your eligible dependent to remain in BHP for a specified number of months at 102% of the current premium cost. Qualifying events include reduced work hours, child reaching 19 and not a full time student in dental plan, child turns 26 in medical plan, death or divorce of a covered employee, and termination of employment.
How do I elect COBRA?
- You must notify you Treasurer or Personnel Department on a BHP Enrollment/Change Form of the qualifying event. Your employer will notify Allied who will send a COBRA notice describing your COBRA rights, the COBRA rates, and an enrollment form. You must decide within 60 days from the date of the notice or the date coverage under the Plan ends if you want to elect COBRA coverage.
  
  COBRA EXAMPLES:
  My daughter will turn 19 and is not a full student. Will she still be covered under my dental plan?
  NO. Her coverage ends at midnight on her 19th birthday.
  You MUST notify your employer within 60 days of her birthday in order to receive COBRA rights.
  
  My son will turn 26. Will he be covered under my medical plan?
  No. His coverage ends midnight on his 26th birthday. You must notify your employer of his birthday in order to receive COBRA rights.
  
  My divorce is final. What steps do I take regarding my ex-spouse's coverage?
  You MUST notify your employer within 60 days of your divorce. Failing to do so will result in a forfeiture of their right to continue coverage through COBRA.
What is a Pre-Existing Condition?
- It refers to any illness, injury or related condition for which you have received treatment during the three months immediately before you became covered under the Plan. Pre-existing conditions does not apply to dependents under age 19.
Can Pre-Existing clause be waived?
- YES, through the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This federal law allows all or part of your pre-existing waiting period to be waived. HIPAA prohibits discrimination based on health status and restricts pre-existing condition exclusions and limitations as long as there is proof of uninterrupted prior medical coverage.
How do I prove that I had previously uninterrupted credible coverage?
- Acceptable ways to establish creditable coverage are...
  1. Certificate of Credible Coverage: Your past employer or health plan will provide you with this document which states the effective date of prior coverage and the termination date for you and any covered dependents.
  2. Coverage under Medicare or Medicaid
  3. Individual health coverage
  4. Coverage under state-risk pool
  5. Coverage through TriCare (coverage for military personnel)
  
  NOTE: The term uninterrupted coverage means that there must not be more than a 63-day break in coverage from one medical plan to another.