Group Health Insurance
Carleton College offers benefit-eligible employees two different plans provided by HealthPartners. Carleton allows same sex and opposite sex domestic partner coverage. Participation is voluntary and health care premiums are taken as a pre-tax deduction.
Benefits are effective the first of the month following your first month of employment. If your employment date occurs on the first working day of the month, your benefits become effective immediately. New employees will have 30 days from the date employment begins to apply for health coverage. If the 30-day period has elapsed, the employee will be considered a late entrant and may be subject to pre-existing conditions. An employee must elect or waive participation through our on line enrollment process (benefitsCONNECT).
A change in options may be made once every year during the Open Enrollment process unless you experience a qualifying event. Open enrollment is offered on an annual basis.
HealthPartners customer service is available Monday through Friday from 7 a.m. to 7 p.m. CT and can be reached at:
- 800-883-2177 (Toll Free)
To file a claim if your provider does not file one for you, please use the Health Partners Claim Form.
Group Health Insurance Plan Options:
HealthPartners Blue Plan (National ONE HSA 1300-80 w/ Rx Plus)
This is a high deductible health plan offering preventative and catastrophic coverage with an employer funded health savings account (HSA). Preventive care is covered at 100%. Drugs are covered based on a percentage after your deductible has been met, however there are some preventative medications that have a co-pay. The list of preventative medications with a co-pay can be found here. You may also receive coverage with non-network providers but can expect higher out-of-pocket costs and other restrictions.
Certificate of Insurance:
Summary of Benefits and Coverage (SBC):
For additional information on Health Savings Accounts please click here to visit the HSA webpage.
HealthPartners Maize Plan (National ONE 500-35)
This option has a copay for office visits, a deductible for other types of care and covers eligible services at 80% after the deductible is met. Preventive care is covered at 100%. Prescription drugs have a copay based on the type of prescription filled. You may also receive coverage with non-network providers but can expect higher out-of-pocket costs and other restrictions.
Certificates of Insurance:
Summary of Benefits and Coverage (SBC):
Medical Plan Premium Information:
The cost associated with health coverage is not pro-rated for less than full-time employees. Participation in the group health insurance is optional.
Other HealthPartner informational links:
- HealthPartners Information Guide
- Prescription Mail Order handout
- HealthPartners Mail Order Pharmacy Link
- HealthPartners Drug Cost Calculator
- Member Support Information
- Virtuwell (24/7 Online Clinic)
- Travel Assistance plan handout
Medicare and Medical Insurance Information
As a general rule, if an an individual entitled to age-based Medicare does not sign up for Medicare Part B when they are first eligible at age 65, they have to pay a penalty if they sign up later. The individual can avoid this penalty if they qualify for a "special enrollment period" (SEP). An individual will qualify for a SEP if they have coverage under an employer's group health plan because of that individual's current employment status with the employer or because they are the spouse of such an individual at the time of Medicare eligibility and then lose that coverage.
If you (the employee) continue to work past age 65 and carry our health insurance, you will qualify for this "special enrollment period" when you decide to end your employment with Carleton College. This is also the case if you carry coverage for your spouse.
However, if you (the employee) have a domestic partner on your Carleton group plan who is nearing Medicare eligibility (at age 65), you'll want to read on for information on ineligibility for your domestic partner to be eligible for the Medicare "special enrollment period" (SEP).
While your domestic partner has coverage under Carleton's group health plan, that coverage is not because of the domestic partner's current employment with Carleton (they are not an employee), nor are they the spouse of such an individual (not married to the employee). As a result, the domestic partner will not qualify for an SEP when the Carleton group coverage ends (e.g. due to the employee's retirement), so the domestic partner would have to pay the Part B late enrollment penalty.
In order to avoid the Part B late enrollment penalty, domestic partners will need to enroll in Medicare Part B when they become eligible for Medicare if they wish to avoid the penalty later.