Eligibility Guidelines

To be eligible for coverage a company must:

• Be actively in business
• Enroll 1 – 50 eligible employees (owners included)
• Contribute 50% of the Individual and 33% of the Family premium
• Be located in the Tufts Health Direct service area
• Be a member in good standing of HSA

ELIGIBLE EMPLOYEES

An eligible employee is one who:

• Works at least  30 hours per week for the employer
• Was hired to work for a period not less than 5 months
• Lives within the Tufts Health Direct service area

New Employees

All future eligible employees can be enrolled within 30 days of hire or within a time frame consistent with company new hire probation policy.

WAIVER OF COVERAGE

Full-time employees can be excluded if they are:

• Covered by a spouse’s or parent’s health plan
• Age 65 or over and covered by Medicare
• Living outside the Tufts Health Direct service area

PARTICIPATION REQUIREMENTS

Groups of 1 – 5

• 100% of eligible employees must enroll.

Groups of 6 – 50

• At least 75% of eligible employees must enroll.

PLAN SELECTION

• All employees must select the same plan.

EFFECTIVE DATES

All coverage will be effective on the first day of the month, contingent on the carrier’s enrollment requirements. Enrollment materials should be received by the 25^th day of the preceding month.