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Health Care RI


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 in the TUFTS 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
  • Resides in the TUFTS 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 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

  • All coverage will be effective on the 1st day of the month, contingent upon the carrier’s enrollment requirements. Enrollment materials should be received by the 25th day of the preceding month.