Eligibility Guidelines

ELIGIBLE COMPANIES

To be eligible for coverage a company must:

• Be actively in business
• Enroll 1-9 eligible employees (owners included)
• Contribute 50% of the Individual and 33% of the Family premium
• Be located within the Tufts Health Plan 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 or works within the Tufts Health Plan 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 who are:

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

PARTICIPATION REQUIREMENTS

Groups of 1-5

• 100% of eligible employees must enroll

Groups of 6-9

• 75% of eligible employees must enroll

PLAN SELECTION

All employees must select the same plan

EFFECTIVE DATE