Cash-in-Lieu of Insurance (CIL) Renewal/Enrollment
Enrollment Deadline: December 3rd (or within 30-days of becoming eligible for new employees)
Eligible full-time employees electing not to participate in the health insurance benefit, upon demonstration of having alternative group-sponsored health insurance coverage (or other qualifying health coverage as defined in the Section 125 Plan) for themselves and their eligible dependents, may elect to receive $2,400 in lieu of insurance (accrued at a rate of $200/month of eligible coverage). Payment for accrued cash-in-lieu of insurance (CIL) benefits shall be paid in two installments – one in June and one in December. Eligible part-time teachers (those working less than 0.80 FTE and at least .50 FTE) electing not to participate in the health insurance may receive a pro-rated sum equivalent to their FTE. This cash in lieu of insurance option is not available to employees who are enrolled as a dependent or spouse of another employee within the District.
In order to elect cash-in-lieu of insurance you must complete and submit the following documents to Sandy Emery prior to the deadline:
- Cash-in-Lieu of Insurance Election of Benefits Form
- Sworn Statement of Alternative Health Insurance Coverage (on the reverse side of the election form)
- Declaration of Health Care Coverage
If we do not receive the completed form outlined above by the deadline stated, you will not qualify for cash-in-lieu of insurance – even if you are not enrolled in the District’s medical insurance plan.
Frequently Asked Questions
Do I qualify for cash-in-lieu of insurance?
To be eligible for the CIL payment you, your spouse (if any), and all your eligible family members who are tax dependents must be covered by other permissible group health plan coverage.
How do I enroll in the cash-in-lieu of insurance benefit?
If you are eligible to receive cash-in-lieu of insurance benefits, you must complete a Cash-in-Lieu of Insurance election form and a Sworn Statement of Alternative Coverage (along with acceptable proof of other permissible medical plan coverage) by the deadline indicate above.
If you are currently enrolled in the District’s group medical insurance program, you will also need to complete a VEHI Enrollment and Change form to voluntarily cancel you coverage with the District (section 3 of the form) along with the Cash-in-Lieu of Insurance election form.
If I completed the Cash-in-Lieu of Election form this year, do I need to complete another election form?
Yes. Cash-in-lieu of insurance is an annual election. If you do not complete the required elections forms each year, you will not be eligible for the cash-in-lieu of insurance benefit for the corresponging plan year – even if you are not enrolled in the District’s group medical insurance plan.
What is considered permissible group health plan coverage?
Permissible group health plan coverage includes the following:
- another employer’s group plan
- a spouse’s health benefit plan, or
- certain governmental plans, such as Medicare Part A, CHIP (Children’s Health Insurance Program), Medicaid, and most TRICARE coverage for military veterans.
Federal tax law prohibits a CIL payment to employees if the employee and/or to their spouse and other family members, are covered by an individual policy of health insurance, including individual policies on Vermont Health Connect.
What qualifies as proof of other medical plan coverage?
Proofs of enrollment in other permissible medical plan coverage include member identification cards, a letter from an insurance company or health plan, a copy of enrollment information, or a letter from another employer attesting to enrollment in that employer’s health plan. All proof of enrollment must show the applicable coverage period.
Can I change my election during the plan year?
If an employee or employee’s family member experiences a change in status (explained below) the employee may make a mid-year election to waive coverage under the District’s group medical insurance plan and enroll in the cash-in-lieu of insurance benefit plan. To do so, notice and proof of enrollment must be provided within 30 days following the qualifying event to be eligible for the CIL payment. The monthly CIL payments will begin for the first calendar month coverage terminates provided the change in status is approved and the certification is accepted.
If you are declining enrollment in the District’s group medical insurance plan for yourself and/or your tax dependents (including your spouse) because of other group medical coverage, you may be able to enroll yourself and/or your dependents in this plan if you or your dependents lose eligibility for that other coverage or if the employer stops contributing towards you or your dependent’s coverage. In addition, in order to claim special enrollment rights for you and your dependents, you must complete and submit to Human Resources a VEHI Enrollment and Change form within 30 days after your other coverage ends or after the employer stops contributing towards the other coverage.
If you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and/or your dependent(s) in the District’s group medical insurance program, even if you waived all coverage under the health plan for your entire family. However, you must request enrollment within 30 days after the marriage, birth, adoption or placement for adoption. To request a special enrollment or obtain more information, please contact Sandy Emery at email@example.com.
What is considered a change in status?
Status changes that permit you to change your election for defined under IRS tax code. A summary of these changes are provided below:
- Changes in marital status (e.g., marriage, divorce or annulment, legal separation, death of spouse)
- Changes in the number of dependents (e.g., birth, adoption or placement for adoption, death of a dependent)
- Changes in employment status that affects coverage eligibility (e.g., termination of employment, commencement of employment, full-time to part-time, part-time to full-time)
- Changes in dependent’s eligibility under the District’s plan (e.g., lost or gained eligibility due to age, student status, marital status)
- Changes in residence affecting eligibility
- Certain court orders, Medicare or Medicaid
Who do I contact with additional questions?
If you have any questions related to this notice, please email Sandy Emery at firstname.lastname@example.org.