Homecare Workers
You are eligible for medical and dental insurance coverage under HUBB if:
1. You are a full-time, part-time, hourly or live-in publicly funded Oregon Homecare Worker; and
2. You are employed through the Client Employed Providers (CEP), Spousal Pay Providers, or Oregon Project Independence and compensated by the Department of Human Services (DHS); and
3. You work 80 or more hours per month for two consecutive months; and
4. You are not covered by any other medical or dental coverage other than Medicare and Veteran’s benefits. If you are covered by another group or individual medical or dental plan, you must cancel that plan in order to be eligible to enroll in HUBB insurance.
Family Members
Family members of homecare workers are eligible for medical and dental insurance under HUBB as follows:
1. If you are married, your legal spouse is eligible for insurance. Your domestic partner of the same or opposite gender is eligible for coverage if he or she meets the eligibility criteria on the HUBB Domestic Partner Affidavit or you present a Certificate of Registered Domestic Partnership.
2.Any child under the age of 26 who is a biological or adopted child or a child placed for adoption of the eligible employee, employee’s spouse, or the employee’s domestic partner and is not covered by any other medical and dental insurance and does not have other employer sponsored medical and dental insurance available to them.
Loss of Eligibility
Employees lose eligibility when their hours-worked are less than 80 hours for two consecutive months. Coverage ends one month after their work hours fall below 80 hours for two consecutive months.
Family members lose eligibility when they no longer meet the definition of family member or when the employee loses eligibility due to a reduction in hours of work.
Once enrolled in the program, employees and family members who lose eligibility may continue coverage through the COBRA Continuation of Coverage program by self-paying the monthly premium.
ENROLLMENT AND EFFECTIVE DATES
Eligible Homecare Workers
Homecare workers may enroll during the qualifying period by completing the Medical and Dental Enrollment Form according to their area of residence. When the enrollment form is received and date stamped at HUBB during the qualifying period, coverage will be effective the first of the month following two consecutive months of 80 hours or more plus the waiting period.
Workers who submit the enrollment form after the qualifying period will receive coverage the first of the month following receipt of the form (date stamped at HUBB) if the employee continues to meet the eligibility requirements.
Re-Enrolling for Coverage
Homecare workers who lose HUBB coverage and then later work enough hours to qualify for HUBB insurance again, may enroll for insurance.
Employees who return to benefit eligible status following a period of ineligibility and loss of coverage must work 80 hours or more for two consecutive months and meet the one-month waiting period to qualify to enroll for coverage.
Employees who return to qualified status after a break in coverage must complete a new enrollment form and submit it to HUBB during the qualifying period. When the enrollment form is received and date stamped at HUBB during the qualifying period, coverage will be effective the first of the month following two consecutive months of 80 hours plus the waiting period.
Family Member Enrollment
Workers may enroll family members for medical and dental coverage as follows:
1. At the time of the employee’s initial enrollment;
2. At the time the employee re-qualifies for coverage;
3. As a result of a status change event; or
4. During Open Enrollment.
5. Family members must be enrolled in the medical plan to be eligible to enroll in the dental plan.
6. Family members cannot participate unless 6. the homecare worker is enrolled in the HUBB plans.
7. Family members cannot be patients (clients) 7. of the homecare worker.
ENROLLMENT CHANGES
Status Change Events
Workers can make changes to their enrollment if the enrollment change request is consistent with and a result of a qualified status change as outlined below. Enrollment change requests must be received and date stamped at HUBB within 60 days of the status change event in order to be honored. When the enrollment form is received and date stamped at HUBB during the 60-day enrollment period for status change events, coverage will be effective the first of the following month as long as the worker continues to meet eligibility requirements.
In the case of a newborn child, coverage will be effective retroactive to date of birth as long as the enrollment form is received (date stamped at HUBB) during the 60-day enrollment period for status change events.
Status Change Events Include:
1. You marry or establish a domestic partnership through Affidavit or Certificate of Registered Domestic Partnership.
2. Your spouse or domestic partner dies; or you divorce or dissolve your domestic partnership.
3. Your biological child is born; you adopt a child or a child is placed with you for adoption.
4. A dependent child dies.
5. A child becomes eligible as a dependent for coverage under your benefit plan.
6. A child is no longer eligible as a dependent for coverage under your benefit plan.
7. Your employment status changes.
8. Your spouse’s or domestic partner’s employment status changes.
9. The cost of your benefit coverage changes
10. You, your spouse or domestic partner or dependent child lose other benefit coverage.
11. a Qualified Medical Child Support Order
12. You, your spouse or domestic partner move out of the plan’s service area.
13. Your family member is approved or denied for a FHIAP premium subsidy or the amount of your FHIAP premium subsidy changes.
Move Out of Service Area
If a worker moves out of the service area of the medical and/or dental plan in which he/she is enrolled and is no longer eligible to participate in that plan, they must re-enroll in the plan available in the new area.
Covered Under another Plan – Loss of Coverage
Workers not enrolled in the insurance plan because they are covered under another plan, who subsequently lose the other coverage, may request enrollment in the Homecare Insurance Program. To establish eligibility after loss of other coverage, HUBB must evaluate eligibility based on a look-back of the reported previous months hours worked. The employee will receive credit for hours worked for the most recent two-month period and the waiting period. If eligibility can be established, the employee’s coverage will be effective the first of the month after the previous coverage is lost. If eligibility is not established with the most recent months look-back, the employee will experience a gap in coverage until eligibility is established.