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Frequently Asked Eligibility Questions

• What Benefits are OPS/Student Employees Eligible to Receive?

  Benefits  

  Health Insurance:  

  OPS/Variable hour employees are eligible for health insurance if:
  

  • At the point of hire, they are reasonably expected to work 30 hours or more per week on average.
  • At the end of their 12-month new hire measurement period, their hours worked averaged 30 hours or more per week.
  • At the end of the 12-month open enrollment measurement period, their hours worked averaged 30 hours or more per week.
  • OPS/Variable hour employees who work less than 30 hours per week on average over the defined measurement period are not eligible for coverage.

  Basic Life Insurance:

  OPS/Variable hour employees who work an average of 30 hours or more each week over the defined measurement period may enroll in the $25,000 basic life insurance plan and pay the entire monthly premium. OPS employees are not eligible for optional term life insurance. 

  Dependent Spouse and Child Life Insurance:
  OPS/Variable hour employees enrolled in basic life insurance are eligible to enroll their legal spouse and dependent children in dependent spouse life insurance and dependent child life insurance, respectively.
  
  Supplemental Plans:
  You can participate in the following supplemental plans by paying the full premium on a pretax basis.

  • Dental
  • Vision
  • Accident
  • Cancer
  • Disability
  • Hospital Intensive Care
  • Hospitalization

  Savings and Spending Accounts:
  OPS/Variable hour employees who are eligible for health insurance can also enroll in:

  • Healthcare FSA
  • Limited Purpose FSA
  • Dependent Care FSA
  • Health Savings Account

  Please visit the  webpage for additional information regarding benefits eligibility.  

• How Is Eligibility Determined?

  People First uses the 12-month look-back method to determine an OPS/Student employee's eligibility for benefits. The 12-month look-back measurement method consists of three different periods:

  1. 1. Measurement Period – counts hours worked for eligibility.

        Initial Measurement Period – An OPS employee who is not reasonably expected to work at least 30 hours per week at the point of hire. This measurement includes service from the first day of the month following the date of hire to the last day of the 12th month of employment.

        An example : An employee is hired October 5, 2018. The initial measurement period will run from November 1, 2018 through October 31, 2019. If the hours worked during the initial measurement period average 30 hours or more per week, the employee is eligible to enroll in the Plan with an effective date of December 1, 2019.

        If a part-time OPS employee at the time of initial hire becomes reasonably expected to work 30 hours or more per week during the open enrollment measurement period, the employee becomes eligible to participate in the Plan at that time.

        Open Enrollment Measurement Period – If an OPS employee has been employed long enough to work through a full measurement period, the worker is considered an ongoing employee. The hours of service are measured during the open enrollment measurement period and determined if eligible during open enrollment. This period runs from October 3 through the following October 2 of each year and will determine Plan eligibility for the plan year that follows the measurement period.

        An example : Assume one is hired January 5, 2018, in an OPS position and is expected to work an average of at least 30 hours per week. The employee is eligible to enroll in the Plan at the point of hire and will continue Plan eligibility through December 31, 2019. The worker will then be measured on October 3, 2019, by looking back at the previous 12-month period to determine if the individual worked at least 30 hours per week. The eligibility for the 2020 plan year will depend on whether the employee worked an average of 30 hours or more per week during the 12-month measurement period or whether the employer reasonably expects the individual to work 30 or more hours per week.

        Plan eligibility will continue until ones hours are measured during the next or second (depending on date of hire) open enrollment measurement period to determine Plan eligibility for the next plan year.
        
        

     2. Stability Period – follows a measurement period. If an OPS employee, the hours of service during the measurement period determines whether one is a full-time employee who is eligible for coverage during the stability period. If the individual is a full-time employee in the stability period, the eligibility is “locked in” for the stability period, regardless of how many hours worked during the stability period, as long as the individual remains an employee of the State of Florida. However, if the employee were a non-full-time OPS employee but become reasonably expected to work 30 hours or more per week during the stability period, the individual becomes eligible to participate in the Plan at that time. For ongoing employees, the stability period lasts 12 consecutive months.
        
        

     3. Administrative Period – the time between the measurement period and the stability period when administrative tasks, such as determining eligibility for coverage and facilitating Plan enrollment, are performed. If an employee is determined to be eligible, a benefits package showing the individual’s available options, costs, and effective dates will be mailed to the mailing address in People First, the system of record.

        The rules for the look-back measurement method are complex, and this is a general overview of how the rules work. More complex rules may apply to each situation. The State of Florida intends to follow applicable IRS final regulations (including any future guidance issued by the IRS) when administering the look-back measurement method. If an employee has questions about this measurement method and how it applies, please call the People First Service Center at (866) 663-4735 weekdays from 8 a.m. to 6 p.m. Eastern time.

• What Can Suddenly Trigger Eligibility?
  1. People First receives an updated PAF (Personnel Action Form). This requires that a department submits an updated PAF to HR stating the OPS employee is expected to begin working 30 hours or more per week moving forward. 
  2. People First uses combined hours worked to determine benefit eligibility for OPS/Student Employees. If an employee is working a secondary job, their combined weekly hours could trigger benefit eligibility. 
• What Happens when OPS/Student Employees Become Benefit Eligible?

  People First will notify eligible employees via mail to their home address and provide plan information as well as steps for how to enroll in eligible plans. The employee has sixty (60) days from the date of eligibility to enroll in benefits.

  • If the employee enrolls in a benefits plan, they will retain coverage throughout the standard measurement period. PeopleFirst will then determine future coverage eligibility based on average hours worked during the measurement period. The department is fiscally responsible for the Employer Contribution associated of all plans in which the employee enrolled.
  • If the employee does not enroll within 60 days from their date of eligibility they will not be eligible to enroll in benefits until they experience a qualifying status change event. Note: Promotion from a benefit eligible OPS position into a budgeted (USPS, A&P, Faculty) position is not considered a qualifying status change event.

EPAFs and Secondary Jobs

• EPAF Process

  An EPAF is required to hire an employee who has previously worked or is currently working on campus. 

  Human Resources' Pay & Leave unit has established the following procedure for processing EPAFs for OPS/Student employees who have an active primary job on campus:

  1. Verify employee is actively working in the primary position
  2. Add the following standardized note in the comment section of the EPAF: Employee has an active primary position on campus working [XX] BW Hours at [.XX] FTE in the department of [Department Name]. An increase in weekly standard hours to 30 or more will trigger benefit eligibility. For more information about OPS/Student benefit eligibility, please visit /hr/benefits/OPS_Benefit_Eligibility.aspx. To proceed with hiring, please re-submit this EPAF with any position updates (if needed). Re-submission of the EPAF will serve as departmental acknowledgement and understanding of the above information.
  3. Return EPAF to Originator for review.

  Please contact Pay & Leave for any EPAF related questions at (904) 620-2903.

• Department Protocols
  The department is responsible for managing the weekly hours of their OPS/Student employees. It should have protocols for managing overtime hours (40 or more hours in a workweek), secondary employment, and other working hours-related issues that could have budgetary implications. It is recommended that departments be proactive and inform employees at the time of hire of any hours-related rules and expectations associated with the position. For example, departments can use the following  to document employee acknowledgment of the position requirements.