Haris Ashley
Indiana University offers medical and dental benefits to employees and their families, provided they meet the eligibility criteria. Full-time employees (75% FTE or greater) are eligible for medical and dental plan enrollment, which must be completed within 30 days of being hired. Part-time employees (50-74% FTE) are also eligible for benefits, except for certain insurance plans. Additionally, Indiana has various health care programs, such as the Healthy Indiana Plan, Hoosier Healthwise, and Hoosier Care Connect, each with specific eligibility requirements based on age, disability status, and Medicare eligibility. Indiana law also allows for deductions in employee paychecks for premiums for employer-sponsored insurance policies.
| Characteristics | Values |
|---|---|
| Indiana University medical insurance eligibility | Full-time (75% FTE or greater) appointed academic and staff employees |
| Indiana University dental insurance eligibility | Full-time (75% FTE or greater) appointed academic and staff employees |
| Indiana University medical insurance enrollment period | Within 30 days of being hired into a benefits-eligible position, within 30 days of an IRS-defined qualifying life event, or during the annual Open Enrollment period |
| Indiana University dental insurance enrollment period | Within 30 days of being hired into a benefits-eligible position, within 30 days of an IRS-defined qualifying life event, or during the annual Open Enrollment period |
| Indiana University medical insurance for J-1 Visa holders | Anthem PPO $500 Deductible medical plan |
| Indiana University medical insurance for newborns | Automatic coverage from birth for 31 days if the parent is covered under an IU-sponsored healthcare plan and the newborn meets the definition of an eligible dependent |
| Indiana University medical insurance for adopted children | Coverage may begin from the point the child is placed with the employee (granted custody) for the purpose of adoption |
| Indiana University medical insurance for dependent children over 26 | May join IU-sponsored health plan(s) within 30 days of the employee’s initial benefit eligibility or within 30 days of losing other qualified coverage if they are fully disabled |
| Indiana University medical insurance for retired employees | May be eligible for group health insurance |
| Indiana Medicaid eligibility | Determined by several factors, including age, disability status, and eligibility for Medicare |
| Indiana Healthy Indiana Plan eligibility | Adults aged 19-64 who are not disabled |
| Indiana Hoosier Care Connect eligibility | Individuals aged 65 and older, blind, or disabled who are not eligible for Medicare |
| Indiana Hoosier Healthwise eligibility | Children up to age 19 and pregnant women |
| Indiana State Health Insurance Assistance Program eligibility | People with Medicare |
| Indiana Consolidated Omnibus Budget Reconciliation Act (COBRA) | Employees, former employees, spouses, employees' former spouses, and dependents can maintain employer-sponsored health insurance coverage after a qualifying event |
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What You'll Learn
Indiana University offers medical insurance to full-time employees and their families
The university provides two types of medical plans: a traditional health plan and a high deductible health plan (HDHP) with a health savings account (HSA) option. Each plan includes prescription drug, mental health, and vision coverage, as well as programs to improve well-being and access to care. Employees can also access employee health centers through Marathon Health for preventive, acute, and mental/behavioral healthcare.
In terms of dependent coverage, eligible individuals include spouses (by marriage, either opposite-sex or same-sex) and children. Newborn children are automatically covered from birth for a period of 31 days, provided that the employee is covered under an IU-sponsored healthcare plan on the child's birth date. For children who are already 26 years or older and fully disabled, they may join an IU-sponsored health plan within 30 days of the employee's initial benefit eligibility or within 30 days of losing other qualified coverage. To continue coverage beyond age 26, documentation and medical certification of their disability status must be provided.
While Indiana University offers medical insurance to its full-time employees and their families, it is important to note that Indiana state laws also allow public employers to provide group health insurance for their employees. These laws specify conditions under which retired employees are eligible for continued insurance coverage, including age and years of creditable employment.
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Retired employees are eligible for Medicare
In Indiana, retired state employees are eligible for Medicare. Medicare is a national health plan for senior citizens over the age of 65 and under 65 with certain disabilities. Retired Indiana Public Employees Association (RIPEA) members can combine Medicare with an Anthem health plan to help round out their health coverage. Anthem Insurance Plan insureds are eligible for special offers and discounts on health care items, personal products and services.
To qualify for Medicare Advantage Plans, you need Medicare Parts A and B. People with End-Stage Renal Disease (permanent kidney failure) generally cannot join. You can only join at certain times during the year unless you qualify for a Special Election Period (SEP). The Medicare Open Enrollment Period allows insureds to switch to another plan or return to Original Medicare and enroll in a Medicare Supplement plan.
Retired employees can choose to join a Medicare drug plan when they sign up for Medicare Part A and/or Part B. If they choose not to join a Medicare drug plan, they will need to have creditable drug coverage to avoid paying a Part D late enrollment penalty. Creditable drug coverage is coverage that provides the same value as Medicare drug coverage. If you have limited income and resources, you may qualify for Extra Help, even if you have creditable retiree drug coverage.
In Indiana, a retired employee's eligibility to continue insurance ends when the employee becomes eligible for Medicare coverage or when the employer terminates the health insurance program. A retired employee who is eligible for insurance coverage may elect to have their spouse covered under the health insurance program at the time the employee retires.
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Employers can provide group health insurance
Indiana University offers medical and dental benefits to employees and their families, provided they meet the eligibility criteria. Full-time employees (75% FTE or greater) are eligible for medical and dental plan enrollment. Enrollment must be completed within 30 days of being hired, within 30 days of a qualifying life event, or during the annual Open Enrollment period.
In Indiana, public employers may provide group health insurance for their employees and retired employees. This includes teachers who retired before May 31, 1986, and other employees who retired after June 30, 1986. Retired employees are eligible if they meet the following criteria: they are at least 55 years old, have completed 20 years of creditable employment with a public employer, with 10 years being immediately preceding retirement, and have completed at least 15 years of participation in the retirement plan. Additionally, they should not be eligible for Medicare coverage. Employers may also choose to provide group health insurance to employees on leave without pay and cover all or part of the premium costs.
Group health insurance plans offer health coverage benefits to a group of members, typically employees of a business or organization. These plans are usually sponsored and purchased by the employer and are often tailored to meet the diverse needs of employees. Employers with 50 or more employees typically buy large-group policies, while smaller employers purchase small-group policies. Group health plans differ from individual health insurance as they are specific to a particular group and are not available through a marketplace insurance provider. Employees can join during specific enrollment periods and can add spouses and dependents, typically for an additional cost.
There are various types of group insurance plans available, such as Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans, which are the most popular. Employers can also opt for self-funded plans, where employees pay premiums to the employer, who then covers health care claims after the deductible and out-of-pocket maximum are reached. Group health insurance plans typically cover medical care costs like physician visits, hospital visits, approved procedures, prescriptions, and therapeutic care. Some plans have expanded to include mental health and alternative treatments. Employers can further support employees by offering Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) to help manage healthcare costs and provide tax advantages.
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Employees can use their HRA to choose their own insurance plan
Indiana University offers medical and dental benefits to employees and family members who meet the eligibility criteria. Full-time (75% FTE or greater) appointed academic and staff employees are eligible for medical and dental plan enrollment. Enrollment must be completed within 30 days of being hired into an eligible position, within 30 days of a qualifying life event, or during the annual Open Enrollment period.
The State of Indiana also offers a Health Reimbursement Arrangement (HRA) to its employees. An HRA is a specific account-based health plan that allows employers to reimburse employees for qualified medical expenses, including monthly premiums and out-of-pocket costs. Employees must be enrolled in individual health insurance coverage to use the funds.
The Indiana HRA is known as the Individual Coverage Health Reimbursement Arrangement (ICHRA). It is a government-approved HRA that allows employers to reimburse employees for individual health insurance premiums and medical expenses on a tax-free basis. This differs from traditional group plans by offering flexibility and employee choice. Employees can shop for plans through the ACA marketplace, private insurers, or brokers, giving them more control over their healthcare choices.
With the ICHRA, employers set a defined, tax-free reimbursement amount for employees to use toward individual health insurance and, if allowed, other medical expenses. Employees can choose their preferred insurance plan and customize their coverage based on their specific needs. This includes factors such as premium, deductible, and coinsurance.
The ICHRA provides a modern alternative to traditional group health plans. It allows employers to manage costs without dealing directly with insurance carriers and gives employees the freedom to choose a plan that best suits their needs.
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Employees can maintain employer-sponsored insurance after leaving
In Indiana, employers with 50 or more full-time equivalent employees (FTEs) are required by federal law to provide affordable health insurance with minimum essential coverage to satisfy the Affordable Care Act's (ACA) employer mandate. However, this does not mean that employers with fewer than 50 FTEs cannot offer health benefits.
Retired employees in Indiana are eligible to continue their insurance coverage, as outlined in the Indiana Code. Specifically, retired employees who were teachers or meet certain age, service, and retirement plan participation criteria can maintain their health insurance. Additionally, retired employees' spouses can be covered under the health insurance program, and their eligibility is generally not affected by the death of the retired employee.
The Family and Medical Leave Act (FMLA) provides job-protected leave for eligible employees of covered employers, allowing them to take time off for qualifying family and medical reasons while requiring the continuation of their group health benefits. When employees return from FMLA leave, they have the right to be reinstated to the same coverage levels, including family or dependent coverages, as before their leave.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that allows employees, former employees, their spouses, and dependents to maintain their employer-sponsored health insurance coverage after a qualifying event. This law applies to employers with 20 or more employees.
Indiana University (IU) offers medical and dental benefits to eligible employees and their family members. While IU-sponsored healthcare coverage typically terminates when employment ends, there are opportunities for individuals to continue their coverage after a change in employment or loss of coverage by a spouse or dependent.
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Frequently asked questions
Yes, Indiana state employees are eligible for medical insurance.
Indiana state employees become eligible for medical insurance on their first day of active employment.
Yes, eligibility criteria vary for full-time and part-time employees. Full-time employees (75% FTE or greater) are eligible for medical and dental plan enrollment, whereas part-time employees (50-74% FTE) are not eligible for flexible spending accounts, Life and AD&D insurance, Critical Illness insurance, and Supplemental AD&D insurance.
Enrollment in a medical insurance plan must be completed within 30 days of being hired, within 30 days of an IRS-defined qualifying life event, or during the annual Open Enrollment period.
Yes, retired employees can continue their medical insurance coverage under certain conditions. A retired employee's eligibility ends when they become eligible for Medicare coverage or when the employer terminates the health insurance program.
