It is your responsibility to notify the Benefits Office immediately if your address changes. To do so, you can call the HR/Payroll Service Center or send an email to address.change@umich.edu.

Eligibility
New Employee or New Eligibility for Health Benefits
Coverage Level
Dependents
Exceptions and Special Conditions
COBRA Participants
LTD Participants
GradCare Members
Lapse of Appointment
Enrollment Information by Phone

Eligibility
To be eligible, active employees must have at least a 50% appointment. Graduate Student Instructors (GSIs), Graduate Student Staff Assistants (GSSAs), and Graduate Student Research Assistants (GSRAs) must have at least a 25% appointment.

New Employee or New Eligibility for Health Benefits
When you enroll in a medical insurance plan, you will be concurrently enrolled in the Prescription Drug Plan. You must enroll within 30 days of your service date (date of hire or eligibility) or the date your appointment was put online by Human Resources Records and Information Systems (HRRIS). Coverage is effective on your service date.

There are no separate enrollment forms for the Prescription Drug Plan. You cannot elect medical insurance without participating in the Prescription Drug Plan. Likewise, you cannot elect the Prescription Drug Plan without participating in a medical insurance plan.

Coverage Level
The University considers prescription drug coverage an essential part of health care coverage and treatment. Therefore, your prescription drug coverage will be at the same level as your medical insurance coverage (you only; you plus your spouse or OQA; you plus one dependent; or you plus one or more dependents) and for the same named dependents as for your medical insurance coverage.

Dependents
You may enroll your eligible dependents at the time you first enroll in a medical plan. Newly acquired dependents-such as a newborn or adopted child, a new spouse, or a new other qualified adult, may be added to your medical and prescription drug plans within 30 days of your acquiring the new dependent. If you do not report the change within 30 days, you may be required to wait until the next Open Enrollment to add the new dependent to your coverage. Coverage is retroactive to the date the dependent is acquired if you apply for enrollment within the required time period.

Report any changes in the eligibility of covered dependents, such as divorce, to the HR/Payroll Service Center within 30 days of the event.

Exceptions and Special Conditions
Active members of AFSCME, Trades, and IUOE have separate prescription drug co-pay designs, with annual adjustments in co-pays, as outlined in their respective union contracts.

For COBRA Participants
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) is a federal law that allows employees and/or dependents to continue certain benefits at their own expense if they become ineligible for these benefits due to termination or change in appointment status.

COBRA participants have the option to elect medical and prescription drug benefits through the University or waive both. They cannot buy drug coverage separately.

After the maximum COBRA coverage period has ended, participants may purchase a commercial product from their respective medical insurance plan vendor. While that product may include prescription drugs, coverage may differ from the University's plan.

For LTD Participants
Long-Term Disability participants are regarded as “actives” for benefits purposes. Their prescription drug coverage is consistent with their secondary job/career family (i.e., AFSCME, Trades, and IUOE) and will continue to do so if they retire. Medical plan premium co-payments, if any, become the responsibility of the retiree upon retirement.

For GradCare Members
Prescription drug coverage provisions for non-employee GradCare members—Fellowship, Scholarship, and Medical School Students —who have their medical insurance and prescription drug plans administered through M- CARE, may differ from those of employees who have their prescription drugs administered by the University. However, their co-pays will be consistent with the plan's three-tier design. Prescription drug coverage for non-employee GradCare members is administered through M- CARE under a rider to the GradCare Certificate.

Lapse of Appointment
If you were enrolled in a medical plan and a lapse of appointment occurred of no more than one term (four months), your coverage will resume when you return to work with an eligible appointment. The Benefits Office will attempt to automatically reinstate your coverage, but it is your responsibility to check your pay stub and verify reinstatement has occurred.

If a lapse of more than one term occurred, you must establish a new date of eligibility when you return work.

A leave without salary or layoff does not constitute a lapse of appointment, and medical and drug coverage may be continued at your own expense during a leave or layoff period.