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Contributory and Non-Contributory Coverage

PW_M010475
Your Guide to Contributory and Non-Contributory Coverage
 

  Contributory Coverage

Enrolling and Submitting Applications

When coverage is contributory (employees contribute toward the premium), each employee should apply for or refuse coverage within 31 days of the date when they and any of their dependents become eligible. If the employee applies for coverage (signified by completing an application with signature and date) later than that 31-day period, the employee will be considered a late applicant and Evidence of Insurability must be submitted. 

The Medical Underwriting Department at Anthem Life will evaluate the application and medical information provided to determine whether the employee and/or dependents will be approved for coverage. Evidence of insurability is also required if the employee applies for an amount of coverage for which we require proof of insurability, or voluntarily terminates their coverage then wants to reapply. 

Meeting Participation Requirements

If employees contribute a portion of the premium for a type of coverage (for example, group term life insurance or short term disability insurance), then at least 75% of all employees eligible for that coverage must be enrolled for it at all times. 

If employees pay the entire cost and the employer does not make any contribution toward the premium for a type of coverage (for example, supplemental life insurance), the minimum percentage or number of eligible employees that must be enrolled varies. Contact Anthem Life for exact requirements. 

 
 

  Non-Contributory Coverage

Enrolling and Submitting Applications

When the employer pays 100% of the premium (employees do not contribute), the employee should apply for coverage within 31 days of the date when they and any of their dependents become eligible. If the employee applies for coverage later than that 31-day period, the employee will be considered a late applicant and a retroactive premium charge will be assessed. Evidence of insurability will not be required.  

Meeting Participation Requirements

When the employer pays the entire cost and employees do not contribute to the premium for a type of coverage (for example, group term life insurance or short term disability insurance), then all employees eligible for that coverage must be enrolled for it at all times. 

If the employer contributes 100% of the premium for dependent coverage, then all eligible employees with eligible dependents must be enrolled for dependent coverage. 

 
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use