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309 Health Insurance

The University offers a choice of four health benefit plans. Membership in a plan is optional. Any regular employee scheduled to work 20 hours or more each week is eligible to participate.

1. The Yale Health Plan (YHP) is a pre-paid health care program providing comprehensive medical, surgical, and hospital care.
2. Two levels of "Indemnity Plans" offer hospitalization insurance, medical and surgical coverage, and major medical coverage, using physicians of the employee's own choice.
3. The Community Health Care Plan (CHCP) is a federally-qualified health maintenance organization (HMO) offering a comprehensive program of medical, surgical, and hospital care on a prepaid basis.
4. Constitution HealthCare Inc. (CHCI) is a federally-qualified HMO providing a comprehensive program of medical, surgical, and hospital care on a prepaid basis. Members may select from among a panel of participating physicians.

Employees may elect coverage for spouses and dependents. Age limits for dependents vary by plan. Subject to the provisions of this policy and the domestic partner policy, an employee with a same-gender domestic partner may enroll the partner in the Yale Health Plan by filing a statement of domestic partnership with the Benefits Office.*

* Same-gender domestic partner provisions effective January 1, 1994

Enrollment in all plans is administered by the Benefits Office.

New employees must sign up for their health insurance within 30 calendar days of their employment date. Failure to do so may require proof of insurability or a waiting period before the insurance becomes effective.

Coverage under any of the plans begins on the first day of the month following the first payment. In order to avoid a gap between coverage under an existing insurance plan and one of the Yale plans, an employee may elect to pay for coverage during the initial month of employment.

Employees may change their medical coverage from one plan to another during the "open enrollment period" that occurs annually. If there is a change in family status, an employee may add or delete coverage within 30 calendar days of the event. If coverage of any family member with another employer is terminated by that employer, and that family member would have been eligible for coverage in the Yale plan, the employee may include that family member in Yale coverage within 30 calendar days of the event.

For continuation of health benefits:

• at retirement, see Section 313.3b
• at resignation or discharge, see Section 317
• at layoff, see Section 107.4.

Descriptive pamphlets and application forms for all of the medical insurance plans may be obtained from the Benefits Office. That office can also provide details of coverage or exclusion for specific types of treatment.