Health Insurance Eligibility Rules

1. The company must be a member of the Association for at least thirty (30) calendar days to become eligible to participate in the insurance program.

2. Only owners, officers, key supervisory personnel and eligible employees of the Exchange member shall be allowed to participate in the group insurance program adopted by the BESA. They must join;

   1. During their initial eligibility period, or

   2. During a BESA open enrollment period, or

   3. A member firm in receipt of a renewal letter from a competitive carrier may join within 30 days of the firms normal renewal. A copy of the renewal letter must be submitted with the application to BESA's designated Administrator.

   4. A member firm offering medical benefits for the very first time. A confirmation letter from the member firm and one competing carrier benefits proposal must be submitted with the application requirements to BESA's designated administrator. A minimum of two (2) full time eligible employees must enroll. Member firm must have been in business for one full calendar quarter.

3. All employees within eligible classification must be accounted for by enrollment or declination forms. A minimum of 50% of all eligible employees must enroll for health insurance. 100% of eligible employees must enroll to be eligible for dental and/or Basic Group Term Life Insurance. Only new employees can be added at a later date. If an employer contributes 100% of employee cost, all eligible employees must enroll.

4. Employer is required to contribute a minimum of 50% of the "Employee Only" Premium.

5. All applications will be thoroughly screened by the BESA designated Administrator for completeness and correct information.

6. All present employees who are eligible may have as their eligibility date the date the employer group becomes effective. All future employees who are eligible shall have as their eligibility date the first of the month following 30, 60, 90, 180, or 365 days of continuous employment as determined by the specific employer group.

7. If your company's eligibility waiting period is other than the standard 30 days of continuous employment, i.e., 60, 90, 180, or 365 days, please include a copy of your requirements with your application agreement. No waiting period beyond 365 days will be accepted by the BESA designated Administrator.

8. Eligible dependents are an eligible employee's spouse and unmarried children from birth to age 19, or extended to the age specified by the sponsored health plan carrier. Sponsored carriers usually extend dependent coverage to age 23 with the provision of full time student status and/or the Internal Revenue Code's meaning of a dependent.

9. All employees shall be required to file written application with the BESA designated Administrator within thirty-one days of marriage, birth of a child, or the legal adoption of a child.

10. Benefits desired must be chosen at the time of enrollment in the program. You may not add or delete or change benefits unless there is an open enrollment period. Exception to this will be qualification under 2c above.

11. All ancillary coverage's, i.e., dental, optical, basic group life/AD&D, group voluntary life, etc., are written on a stand-alone basis through the BESA. (with the exception of  ASHP Complimentary Health Plan Rider). However, if you elect ancillary coverage and drop it, you may not enroll in ancillary coverage for twelve months.

12. If dental, optical, or any ancillary coverage is selected, enrollment must be in accordance with the sponsored carrier's requirements.

13. Only a Builders Exchange Service Association, Inc., (BESA) designated Administrator will bill individual groups, collect insurance premiums and remit on a master bill to sponsored insurance carriers.

14. The BESA designated Administrators employ an open door policy to all participating insurance carriers to audit their Administrative Procedures in compliance with their contract.

15. The health plans sponsored by participating BESA members will be subject to any State or Federal legislation and the benefits and rates will be adjusted to comply in accordance with sponsored carrier policies.