HR & Payroll Resources

To continue coverage, employees must submit updated enrollment forms to reflect the employing agency change. Employees who transfer from one agency to another cannot change from one medical plan to another, nor change their pre- or post-tax Premium Only Plan elections.

Employees who previously declined dependent dental coverage cannot obtain it until the next open enrollment period.

While on authorized LWOP, employees may elect to continue medical, dental, Basic Life, Voluntary Term Life and State Police Optional Life coverages for up to six (6) months (twelve [12] months for authorized employer-sponsored leave for professional and educational purposes). To continue coverage, employees must self-pay the total monthly premium, including the state contribution, for each continued plan.

Employees self-pay by sending your agency monthly checks or money orders made payable to the Office of Group Insurance. Cash payments are not accepted. You in turn will need to complete the appropriate Self-Pay Reporting Form and send it to OGI along with all self-pay checks attached, no later than the fifth (5th) of the month for which the payment applies.

After reaching the maximum LWOP self-pay period, employees may continue medical and/or dental for a period of time under COBRA and apply for conversion of life insurance coverages to individual policies.

While on approved FMLA leave, employees may continue medical, dental, Basic Life, Voluntary Term Life and State Police Optional Life coverages.

To continue coverage, employees must pay their share of the monthly premiums and your agency must continue to pay all employer premiums. Employees who continue to receive paychecks while on FMLA pay their share of the premiums through payroll deductions. Employees who are not receiving paychecks while on FMLA must self-pay their share of premiums by sending monthly checks or money orders to you, made payable to the Office of Group Insurance. Cash payments are not accepted. You in turn will need to complete the appropriate Self-Pay Reporting Form and send it to OGI along with all self-pay checks attached, no later than the fifth (5th) of the month for which the payment applies.

When FMLA ends, employees who continue to be on approved leave without pay may continue coverage for the balance of the six (6) month LWOP period by self-paying the total monthly premium, including the State contribution. After reaching the maximum LWOP self-pay period, employees may continue medical and/or dental for a period of time under COBRA and apply for conversion of life insurance coverages to individual policies.

For the first six (6) months of military leave, employees may continue coverage for themselves and their eligible family members the same as described for Leave Without Pay. However, your agency must continue to pay the employer contribution for the first thirty (30) days of the employee’s leave.

After the six (6) month LWOP period ends, employees may continue medical and dental coverages for themselves and dependents under COBRA. Basic Life and Voluntary Term Life may be converted to individual policies.

To resume coverage, returning employees can re-enroll themselves and eligible family members in the same plans in which they were enrolled before they went on leave. Please contact our office for re-enrollment instructions specific to employees returning from military leave.

State-paid coverage is effective the first (1^st) of the month following the date the new enrollment form is submitted (or immediately when returning from military leave, provided the new enrollment form is completed within thirty [30] days).

If employees allowed their coverage to lapse while they were on LWOP, all contract provisions, including new annual deductibles, out-of-pocket maximums and waiting periods, will apply the same as for new enrollees.

For employees returning from military leave, participation will resume at the same status in which they left. This means, for example, that the time an employee was covered before the leave will count toward satisfying medical plan waiting periods for pre-existing conditions; and, if the employee returns within the same plan year as the leave began, any amounts he or she paid for covered expenses before the leave will still count toward satisfying that year’s medical or dental plan deductibles or out-of-pocket maximums.

For employees who previously declined dependent dental coverage, the declinations remain in effect when they return from leave.

If coverage did not lapse, no re-enrollment is necessary but you will need to ensure that premium deductions resume. If the employee allowed coverage to lapse, you will need to ensure that the premium deduction does not resume when payroll is reactivated. If the employee wants to re-enroll, he/she must provide evidence of good health before coverage can be activated. Please refer employees to our office for assistance. If an application is approved, we will advise you of the effective date.

Employees returning from military leave, who allowed the policy to lapse, may resume coverage without a health statement as long re-enrollment occurs within thirty (30) days. If coverage did not lapse during military leave, no re-enrollment is necessary but you will need to ensure that the appropriate premium deductions resume.

Employees who go on leave and subsequently return within the same plan year must resume participation in the FSA. You will need to ensure that payroll deductions are activated when employees return to active status.

Employees who go on leave and do not return to work until a different plan year cannot re-enroll in the FSA unless they were on military leave. Please contact our office for re-enrollment instructions specific to employees returning from military leave.

In general, employees simply show their plan identification cards to providers at the time of services. The providers then bill the plans directly.

When employees are required to file claims (for example, if services are provided by a non-participating provider who will not bill insurance), they send their itemized receipts and claim forms (downloadable from the carriers’ websites) directly to the applicable carrier.

When an active employee or the dependent of an active employee passes away, beneficiaries may obtain a life claim form from our office or from you. Beneficiaries must complete Parts II, III and IV of the form and return it to you along with a certified copy of the death certificate; you will need to complete Part I, attach the employee’s initial enrollment form and any subsequent change of beneficiary form(s) (if the claim is on an employee) and send everything to our office.

In the event of a Basic Life dependent claim, it is not necessary to include the enrollment/beneficiary form because the beneficiary is always the employee. If an employee is submitting a Voluntary Term Life claim on a dependent a copy of the VTL enrollment form will need to be included.

The Basic Life insurance policy also includes an “Accelerated Benefit Option” or ABO. The ABO allows a terminally ill employee with a life expectancy of twelve months or less to be paid up to half of his or her Basic Life insurance benefit prior to death. More detailed information and the necessary claim form can be obtained from our office.

To obtain a claim packet, employees, their representatives or the agency human resource office should contact the Office of Group Insurance.

If an employee files a claim, we will contact your office to obtain the employment related information necessary to process the claim.

We will also apprise each employee who files a claim what his/her options are for continuing group insurance coverages while on disability.

Annual open enrollment is the only time that employees may enroll/dis-enroll, switch medical plans, change Premium Only Plan elections or enroll in the FSA. Open enrollment is usually held at the end of April and beginning of May, with changes taking effect the following July 1. All employee elections must be submitted during the open enrollment period; forms submitted after the close of open enrollment cannot be accepted.

Each year, the Office of Group Insurance sends all agencies instructions in advance of the upcoming annual open enrollment. We include such details as the exact dates of the open enrollment period and employee deadlines for submitting election forms. We also post information for employees about available benefit options, upcoming changes, and how to enroll for the benefits of their choice on both the Employee Portal employee.idaho.gov/ and the Group Insurance website. It is the responsibility of the individual agency human resource office to share all open enrollment information/materials provided by the Office of Group Insurance to their employees.

Employees have sixty (60) days to enroll new family members acquired through marriage, birth or adoption. Coverage for a new spouse or stepchildren will begin the first of the month following the date of marriage. Newborns and newborn adoptive children have coverage on their date of birth; adoptive children older than sixty (60) days will have coverage effective on their date of placement with the employee.

There is no retiree Basic Life policy for the majority of retirees. However, eligible retirees from the following agencies do have coverage: Judges and Justices; Department of Labor; Idaho State University, Boise State University, Lewis-Clark State College and Eastern Idaho Technical College.

The individual agencies make the eligibility regulations, apprise their employees if they are eligible for coverage and pay the premiums to the Office of Group Insurance. Basic Life coverage for retirees can vary based on age and position.