Initial Eligibility Enrollment Period:
We are excited to be able to provide your Health & Wellness Benefits as of the 1st of the month following your date of eligibility. Because of the tight enrollment period leading up to your effective date, it is important that you do not delay completing your enrollment paperwork.
If you are a Lee County Board of County Commissioners new hire and your position is benefits-eligible, please make sure you complete the following steps to ensure timely enrollment. (If you are an employee of a participating constitutional entity, please check with your specific HR department for instructions on how to enroll):
- Download and review the Benefits Guide and Benefits Video on the Benefits Resources page to determine which benefits you would like.
- Read and review information on the Florida Retirement System (FRS) plans.
- If you are married, download the Spouse COBRA form and bring completed copy signed by your spouse to New Hire Orientation.
- If you are adding a spouse or dependent(s) on any of your benefits, please bring Legal Documentation to orientation if applicable (please see below for acceptable documentation).
- On orientation day, you will receive a benefits overview presentation and paper enrollment packet. This will be your opportunity to ask our Benefits Specialists questions on the plans we offer.
- Complete and submit your benefits paperwork to Human Resources timely and ensure all forms are completed in their entirety to ensure you do not have any delays in enrollment and coverage. Delays may also result in catch-up benefit deductions from your paycheck.
Eligibility:
Lee County Government provides group insurance benefits to all eligible employees, their legal spouses, and their legal dependents under the age of 26 under our regular rates. The Employee Benefits Guide found on our Benefits Resources Library page provides a general summary of the benefit options as a convenient reference.
Eligibility for Coverage from Age 26-30 and Affidavit of Dependent Eligibility:
At the end of the month in which a covered dependent attains the age of 26, he/she will no longer be eligible for coverage and will be dropped from all insurance plans.
The employee may elect to continue their dependent(s) coverage in the medical plan only and pay an additional premium for each dependent covered in the 26-30 age group. For the plan year 2024, that rate is $1,180 per month in addition to any other applicable tier of medical premiums.
The dependent(s) must meet the eligibility requirements, and an Affidavit of Dependent Eligibility (26-30 years old) must be completed for each dependent in order to continue coverage for that dependent. For employees who currently access this benefit, you must complete and verify dependent's eligibility each year during open enrollment. If your dependent is permanently disabled, please contact the Benefits team to discuss your options.
-----------------------------------------------------------------------------------------------------------
To add a Spouse:
- Birth Certificate, Driver's License or Passport
- Social Security Card
- Marriage License
- COBRA Spouse form signed by your Spouse
To add a Dependent:
- Birth Certificate
- Social Security Card
- Legal documentation for adoption, fostering, or court appointed guardianship
- Stepchildren: Marriage License, Birth Certificate and Social Security Card
Open Enrollment:
After your initial eligibility enrollment period, Open Enrollment is your only opportunity to make changes to your coverage, unless you experience a qualified change in status. Open Enrollment takes place every fall for a January 1 effective date for the following calendar year. Please make sure to look for email communications and instructions on when and how to make enrollment changes during the Open Enrollment period.
Qualifying Events:
A "Qualifying Event" is when you experience a change in your situation — like getting married, divorced, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance or make eligible changes in enrollment outside of the yearly Open Enrollment Period.
"Qualifying Event" includes but is not limited to:
- Marriage, divorce, or annulment;
- The birth or adoption of a child;
- The death of your spouse or child;
- A change in the number of your dependents;
- A change in employment status for you, your spouse, or your dependent that results in a change of insurance eligibility.
If you experience one of these events, please contact the Benefits Team immediately. A qualifying event must be reported within 60 days of the date of the event. It is your responsibility to notify the Benefits team and provide required paperwork within this timeframe.
Please note: A divorce changes the eligibility for your spouse to participate in Lee County benefits. If your divorce decree states that you must maintain coverage for your spouse, you still need to contact Benefits within the timeframe above in order to avoid any penalties. If benefits continuation is mandated for your spouse via the final dissolution of marriage, benefits for divorced spouses will need to be maintained through COBRA at the COBRA rate.
Failure to report a qualifying event or change in eligibility timely will result in a reversal of claims, which will become your financial responsibility. Additional penalties may apply.
New additions to our plans as a result of a qualifying event will not be allowed past the required qualifying event reporting period.
Please notify Benefits immediately and complete the Qualifying Event Enrollment Packet.
*Due to Health Care Reform policy changes, the above-mentioned status changes for dependent children may be subject to revision based on future amendments to regulations that govern "changes in status" for cafeteria benefits plans.
Please contact the Benefits team with any questions at 239-533-2245 or benefits@leegov.com.