Benefits

Health Insurance provides financial assistance in meeting your family's health care needs. You have the peace of mind that you and your loved ones will be taken care of in times of illness. Preventive health care can provide for a longer and healthier life. Health insurance is another important benefit that Mason offers to help its employees.

Without health insurance, your health care costs become your sole responsibility. While the decision to purchase health insurance is a personal one, Mason prides itself on offering four different programs with different costs, provider networks and benefits to help meet your family's health care needs. With health care costs always on the rise, even a minor illness could cost you more than your annual premium.

The Commonwealth of Virginia provides health insurance coverage to full-time employees and part-time faculty and classified staff who work at least 30 hours a week, as well as their eligible dependents.

Faculty and Staff who work a minimum of 20 hours but less than 30 hours per week are also eligible for health insurance but pay the Total Premium (Employer and Employee portions), payroll-deducted on a pre-tax basis.

The Commonwealth of Virginia and George Mason University do not formally offer health insurance to part-time employees who work less than 30 hours a week. Employees and their dependents may enroll in one of the individual and family health insurance plans. The employee will be responsible for paying the entire insurance premium if they and/or their dependents enroll in one of the health plans. Payroll deduction is not available for these premium payments. The insurance company can direct bill you on a monthly basis.

Eligible employees have three opportunities to enroll, within the first 30 days of employment, during annual open enrollment or within 60 days of a qualifying life event.

First 30 Days of Employment

Employees must enroll within 30 days of employment. Employees who waive health insurance when first hired, can only elect coverage under a qualifying event or during the annual open enrollment. Coverage is effective on the first of the month coinciding with or following the date of employment.

Annual Open Enrollment

Each spring, the state holds an annual health insurance Open Enrollment period to allow employees to change their health plan/options or membership levels. HR & Payroll communicates open enrollment dates to the university community.

Within 60 Days of a Qualifying Event

Membership changes can be made within 60 days of a qualifying mid-year event and will take effect on the first of the month following receipt of a completed enrollment form. If you don/t qualify for the state-sponsored plan but need health insurance coverage, see the information on available direct pay insurance plans.

To learn more, please visit our health insurance page.

You should receive your welcome packet and health insurance card information within 10-14 business days after the effective date of your coverage and it will be mailed directly to you from the provider to the address you had listed on your enrollment form.

Should you need to contact Cova Care after the effective date but before you receive your welcome packet and id card, you can call Cova Care at 1-800-552-2682 or https://www.anthem.com/ The group id number is 12000000. Your plan id number is YTX(then your state id number)XU.

Should you need to contact Kaiser Permanente after your effective date but before you receive your welcome packet, you can contact Kaiser Permanente at either http://my.kp.org/commonwealthofvirginia/ or member services at 800-777-7902 (DC only 301-468-6000) Each person covered by Kaiser must select a primary care physician.

Should you need to contact Cova Health Aware after the effective date but before you receive your welcome packet and id card, you can call Aetna at 855-414-1901 or www.covahealthaware.com Your plan id number is 00(then your state id number).

Another good link for information about your benefits is the Virginia state site at http://www.dhrm.virginia.gov/healthcoverage. There is a ton of information on this site, including plan specific flyers and the Spotlight on Your Benefits brochure that was provided to you during your new hire orientation.

You have 60 days from the date of your qualifying mid-year event to add or remove a family member from your health insurance plan. You must submit your completed State Health Benefits Enrollment form and provide proof of your qualifying event as well as required documentation.

After you submit your enrollment form and required documentation, your family member will be added to or removed from your health insurance on the 1st of the following receipt of required documents. For instance, if your paperwork is submitted on June 15th, we will begin or remove coverage on July 1.

Please see the section below to learn how to add a newborn to your health insurance plan.

You have 60 days from the date of birth to add your newborn under the Qualifying Mid-year event rules. You must complete a new State Health Benefit Enrollment form and provide proof of birth. We will accept either a birth certificate or the birth letter that the hospital gives you as proof of birth. If you submit both the enrollment form and proof of birth within 60 days of the birth, we will go back to the 1st of the month during which the baby was born to start coverage. For instance, if the baby was born on July 20 and you submit the required documentation on August 31, we will begin coverage on July 1 for the newborn.

Spouse- A photocopy of marriage certificate and a photo copy of the top potion of the most recent federal tax return showing dependent listed as “spouse”- Social Security Numbers and finances redacted.

Natural or adoptive son/daughter- Photocopy of birth certificate or legal adoptive agreement.

Stepchild/children- Photocopy of birth certificate, photocopy of marriage certificate showing employee and dependent parent’s name, and photocopy of the top potion of the most recent federal tax return showing dependent listed as “spouse”- Social Security Numbers and finances redacted.

If adding a family member(s) due to a Qualifying Midyear Event, please provide a letter from previous employer or health insurance carrier with effective date of cancellation and the names of individuals who were covered under the employees plan.

A complete list can be found at the following document: Eligibility for Coverage

The provider mails out one card to the participant of the plan. If you need additional insurance cards, you would need to order them by calling your respective insurance provider. For COVA Care (Anthem Blue Cross Blue Shield), contact 800-552-2682. For COVA HealthAware (Aetna), contact 855-414-1901. For Kaiser Permanente HMO, contact 800-777-7902.

Your child will no longer be covered under your health insurance policy through GMU at the end of the year he/she turns 26. That means that the last day of coverage is 12/31. The State will automatically remove your child, but will notify you approximately 6 to 8 weeks in advance of 12/31. Along with the notice, you will receive a letter explaining what it would cost for your child to continue with the same coverage. If your child chooses to continue with the same plan, your child will have to pay the entire cost; there is no contribution from George Mason. Your child may choose to explore other coverage options… a policy from his/her employer if employed or a policy from healthcare.gov.

If you turn 65 and are still working you may enroll in Medicare Part A. It is extra Hospitalization coverage and there is no premium. You should NOT enroll in Medicare Part B, the doctor coverage, because you have coverage with your Mason health plan as an active employee. Also, Medicare Part B has a premium. You can find more details on the medicare website.

No, the dental and vision plans are only available if you also participate in a health care plan.

No, all family members will be on the same health care plan.