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Medical Coverage

In providing medical coverage to employees and retirees, St. Louis County participates in a program of self insurance. The County contracts with a health insurance company to administer the claims and health care coverage for subscribers. Because the County is self-insured, subscribers are encouraged to be prudent in obtaining health care services. In this way, subscribers may assist the County in its effort to curtail the increasing costs of health care.

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Enrollment: Permanent and probationary employees are eligible for health coverage effective the first day of the month following their first full calendar month worked.  New subscribers must complete and submit a group coverage form.  It is extremely important to enroll within 30 days of becoming eligible. Subscribers over the age of 19 who submit an application outside the 30 day window may be subject to a pre-existing condition waiting period.


Dependents:  Spouses and children of employees and retirees are eligible for family health coverage.  The ONLY factor that affects a child's eligibilty for coverage is the child's age.  A child can remain covered through the end of the calendar month in which he/she turns 26 year's old.  The child's marital status, student status, and residency have no impact on eligiblity.  However, a child covered under the health plan during a calendar year in which the child is not a dependent on the parent's tax return could generate a state tax liability to the parent if the parent is a Wisconsin resident.  There is no tax consequence for parents with Minnesota residency.   Unmarried grandchildren are eligible if they reside with and are financially dependent upon the grandparent continuously from birth.  


Adding/Removing Coverage:  Medical coverage can be changed at any time of the year by submitting a Group Coverage form.  If adding coverage and your form is not timely, a pre-existing condition wait period may apply.  If removing coverage and your form is not timely, a delay could occur in removal from the plan.

A timely form is one submitted within 30 days of first becoming eligible or within the applicable timeline for a qualifed family status change event.  Such events include, but are not limited to, the birth/adoption of a child (90 days), marriage (30 days), divorce (60 days), or loss of other coverage that was in place when first eligible under this plan (30 days).  

Coverage becomes effective on the date of the birth, adoption, or marriage and coverage ends on the first day of the month following the month in which a divorce is finalized. Otherwise, the effective date of the change is the the first day of the month after the form is submitted.

Continuation of Coverage (COBRA):  Employees who separate from employment with the County for reasons other than gross misconduct may extend coverage for themselves and their covered dependents for up to 18 months at their own expense. Employees separating from employment will receive written notification of the right to continue coverage.

An option to continue coverage for up to 29 months is available to employees who are disabled at the time that they separate  employment from the County.

An option to extend coverage for up to 36 months is available to the following qualified beneficiaries of a current employee:
a. Spouses of Medicare eligible retirees still in health plan;
b. Dependent children who reach the limiting age (26th birthday).

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