UT Benefits for Employees

Eligibility

Employees

You are eligible for benefits as a full-time employee if:

You work at least 40 hours per week or have a full-time appointment, and your appointment is expected to continue for at least 4 ½ months, and you are not currently insured by another state-sponsored medical insurance plan.

At some institutions, nurses may be eligible for full-time benefits if they work less than 40 hours per week. Contact your institution Benefits Office for more information.

You are eligible for benefits as a part-time employee if:

You work at least 20 but less than 40 hours per week, or have at least a 50% appointment and your appointment is expected to continue for at least 4 ½ months, and you are not currently insured by another state-sponsored medical insurance plan.

Certain non-employee Post-Doctoral Fellows and Graduate Students are eligible for UT Benefits. Please contact your institution Benefits Office for more information.

Dependents

You may also enroll your eligible dependents for certain UT Benefits coverage.

Eligibility to participate in certain UT Benefits coverage as a dependent is determined by law. Because of changes made by the federal Affordable Care Act (ACA), your children (including stepchildren and adopted children) are eligible for the UT SELECT Medical plan, regardless of marital status, until they reach the age of 26. Eligibility of dependents who do not qualify as your spouse or child (such as eligible grandchildren), ends at age 25 for all UT Benefits coverage, including the UT SELECT Medical plan.

Eligible dependents are:

  • Your spouse, as defined by Texas Family Code;
  • Your children, including stepchildren and adopted children, who are:
    • under age 26 regardless of marital status for the UT SELECT Medical plan,
    • unmarried and under age 25 for other UT Benefits (Dental, Vision, Life, AD&D);
  • Your unmarried grandchild(ren) under age 25, provided the child meets the requirements which includes proof that you claim the child as your dependent for federal tax purposes;
  • Certain children over age 25 (over age 26 for the UT SELECT Medical plan), who are determined by OEB to be medically incapacitated and are unable to provide their own support; and
  • Children for whom you are named a legal guardian by a court or who are the subject of a medical support order requiring such coverage.

Examples of dependents who are not eligible for UT Benefits include:

  • your former spouse;
  • your married child (for coverage other than UT SELECT Medical);
  • your child over age 25 (age 26 for UT SELECT Medical), if not medically incapacitated and unable to provide their own support;
  • your grandchild, if they are married or over age 25;
  • foster children covered by another government program, unless coverage is required by law or court order;
  • any dependent insured by another UT employee or retired employee;
  • any dependent insured by another plan that receives State of Texas premium contributions; or
  • any dependent who is on active duty in the armed forces of any country (for coverage other than UT SELECT Medical).

Surviving Dependent Benefits

The surviving spouse or other benefits-eligible dependent of an employee or retired employee who, on the date of the employee’s death, had at least five (5) years of Teacher Retirement System of Texas (TRS) or Texas Optional Retirement Program (ORP) creditable service, including at least three (3) years with UT as a benefits-eligible employee at the time of death, is eligible for benefits as a surviving dependent if the dependent had been participating in UT Benefits at the time of the employee or retired employee’s death.

A surviving spouse may continue UT Benefits coverage for the remainder of the surviving spouse’s life. A dependent child may continue until the child loses his or her status as a dependent child. The dependent of an individual who has not met the service requirements at the time of death may elect COBRA coverage for a period not to exceed 36 months.

Dependent Documentation

UT requires supporting documentation when you request to add a dependent to your plan. Be prepared to provide proof of eligibility such as your marriage certificate, your child(ren)’s birth certificates, appropriate adoption paperwork, federal tax forms or other documents that support the dependent relationship. For medically incapacitated dependents, proof of the incapacitating condition and dependency must be submitted within 31 days of initial eligibility for enrollment and an incapacitated dependent. This paperwork is required not only to support the coverage of eligible dependents but also to support a mid-year change of status such as marriage or birth of a child.

Misrepresentation of benefit eligibility requirements constitutes a violation of OEB’s official policy. A verified misrepresentation by an employee or retired employee shall be reported by OEB to the appropriate institution for investigation and possible sanctions. Possible sanctions for such a violation range from a reprimand to dismissal. In addition, reimbursement may be required for any benefits paid to an ineligible individual. Deliberate misrepresentation of dependent eligibility by an employee or retired employee may constitute criminal fraud and may result in a referral to a law enforcement office. Any ineligible dependent may be terminated from plan participation upon discovery of ineligibility.

During Annual Enrollment, completed dependent documentation must be submitted electronically by August 15. If you’ve added a dependent and you are not able to complete electronic dependent documentation, you may submit the documentation to your local HR/Benefits office by the same deadline of August 15.

 

The Seal of the University of Texas System

  • © 2013 The University of Texas System
  • 702 Colorado Street, Suite 2.100
  • Austin, TX 78701
  • Phone: (512)499-4616
  •