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Rules for Making Changes to Your PASSHE Health Care Coverage

If you are enrolled in a PASSHE health care plan, it is your responsibility to ensure accurate information is on file with the Office of Human Resources with respect to your personal information (i.e., address changes) and your dependents, reporting changes as they occur (i.e., marriage, birth or adoption, divorce) in a timely fashion (within sixty days of event). This includes the timely submission of the appropriate support documeation and, if applicable, the adult child attestation form.

Rules for Making Changes to your PASSHE Health Care Coverage

You must make a plan option change within sixty days of a qualifying event. Plan option changes include enrolling in a plan if currently waiving coverage, waiving coverage if currently enrolled in a plan, adding eligible dependents to your current plan, or removing currently enrolled dependents from your plan.

All changes to your plan must be made by submitting a PASSHE enrollment/change form to the Office of Human Resources. If you do not submit a PASSHE enrollment/change form to the Office of Human Resources within sixty days of the qualifying life event, you will not be able to make a plan change until the next Open Enrollment for a coverage effective date of July 1. This change in rules is being made to comply with tax code regulations governing the pre-tax employee contributions.

You must make a plan option change within sixty days of the following qualifying life events, or else wait until the next Open Enrollment:

  • You lose other health coverage under your spouse’s plan
  • You move to an area outside of your current plan’s service area
  • You move to an area where a different plan option is available

Note: Faculty members receive vision, dental, and hearing benefits through the Pennsylvania Faculty Health and Welfare Fund. Changes to these benefits must be made by contacting either the local APSCUF Office or the Fund Office directly. Further information on these benefits is available at the Pennsylvania Faculty Health and Welfare Fund website.

Adding Eligible Dependents

You may add a dependent for PASSHE health coverage due to a qualifying life event. The change must be made within sixty days of the qualifying life event. If you do not submit a PASSHE enrollment/change form to the Office of Human Resources within sixty days, you will not be able to add your dependent until the next Open Enrollment period for a coverage effective date of July 1.

You may add a dependent to PASSHE coverage for the following qualifying life events:

  • You gain a dependent through birth or adoption
  • You get married or enter into a qualifying domestic partnership
  • Your dependent loses coverage under another employer’s plan, other than for failure to pay premiums or other cause

Removing Dependents

You are required to remove a dependent from coverage when your dependent is no longer eligible for PASSHE coverage. Examples include:

You lose a dependent through divorce, termination of a domestic partnership, or death. Two related points:

  • Separation is not a qualifying life event in Pennsylvania.
  • You are not permitted to remove a spouse from coverage until a divorce is final or until the next Open Enrollment.

Failure to notify the Office of Human Resources through the completion of a PASSHE enrollment/change form may result in loss of continuation of PASSHE coverage (COBRA benefits not being offered) and/or loss of retroactive premium refund if the event results in a change to the tier in coverage (i.e., family to two-party contract). In addition, if claims are incurred and paid on a dependent that was not terminated within sixty days of event (the Office of Human Resources was not notified), you as our employee will be liable for any claim payments made that cannot be recouped from the insurance vendor. PASSHE policy requires that active or retired employees who receive overpayments in employee benefits, whether through administrative error or oversight, repay the amount of overpayment.

For all mid-year benefit changes that are made retroactively, the retroactive portion of the payroll deductions will be made on a post-tax basis; the prospective payroll contributions will continue to be made on a pre-tax basis. The effective date of the benefit change will be the date of the event (i.e., date of birth, date of marriage, etc.).

  • Human Resources Office
  • Sutton Hall, Room G8
    1011 South Drive
    Indiana, PA 15705
  • Phone: 724-357-2431
  • Fax: 724-357-2685
  • Office Hours
  • Monday through Friday
  • 8:00 a.m.–4:30 p.m.
  • ***************************************
  • Human Resources will either be closed or have limited staffing between Wednesday, December 24, 2014, through Friday, January 2, 2015. Other than automated e-mail responses, there will be no action taken on inquiries or submissions to job postings during this time. Business will resume on Monday, January 5, 2015.