Medical, Dental and Vision Insurance
Employees become eligible for Insurance after 60 days of continuous employment if they work at least 24 “service hours” per payroll period (see below for definition of “Service Hour”)
The company contributes 50% of the monthly medical premium for employees.
The company does not contribute toward the premium for spouses or dependents, but eligible employees can add spouse and dependent coverage at their own cost.
If the company changes or discontinues coverage, it will attempt to give a minimum of 30 days notice. If coverage is discontinued, it would be a “qualifying event” and you would be eligible for an individual insurance plan. Be aware that insurance companies typically raise prices every year and offer less coverage for more money. Because of this, we occasionally change carriers depending on the plans they offer.
Medical Insurance Eligibility
Waiting Period - Employees are eligible for medical insurance after 60 days of continuous employment if “Minimum Hours of Service” requirement is met.
Minimum Hours of Service - The company cannot afford to provide benefits to commissioned employees that do not contribute substantially to revenue production, therefore a minimum number of “Service hours ” are required each payroll for the company to contribute toward Health Insurance. IRS dictates any employee that averages at least 30 hours of service per week, or 130 hours of service per month is eligible for the Medical Insurance Benefit if medical insurance if offered.
The company’s minimum Service Hours to receive medical insurance is significantly less restrictive than federal law requirements. 24 hours of service hours per week, or 48 hours of service hours per payroll period are required to get the company contribution.
“Service Hour” Defined by the IRS is an hour paid, or entitled to be paid, PTO hours used count as hours of service.
For commissioned stylists, an hour of service is an hour working in the salon on a paying client, or PTO hours used.
For hourly employees, an hour of service is an hour working in the salon on any task, or PTO hours used.
Hours on-call, hours scheduled but not eligible to be paid, and hours blocked on the schedule do not count as hours of service.
Temporary Drop in Hours of Service - If an employee averages less than 48 hours or service per payroll period the company will not cover it’s portion of the insurance premium. The employee can either cover 100% of the premium for that payroll period, or be dropped from coverage. If dropped, they can re-enroll during the next open enrollment period assuming they meet the eligibility requirements. The salon cannot afford to contribute toward the premiums for an employee with less than 48 service hours per payroll period.
Dental and Vision Insurance
The salon offers Dental and Vision insurance but does not contribute towards the employee premium. This insurance is very inexpensive. An employee must average 8 hours of service per week or 16 hours of service per payroll period to be eligible for Dental and/or Vision insurance.
Continuation of Medical Coverage After Separation
Your coverage through the company's group plan will end on the last day of the month that you separate from the company. Our company isn't currently eligible for the federal COBRA program; companies must have a minimum of 20 employees in the current and previous year.
Your options for insurance after you leave our employment if you’re new employer doesn’t offer it, are to go on the Marketplace and get an individual plan since your termination is a “qualifying event” (unless you were terminated for “gross negligence”), to et a private plan, or to continue coverage on the company plan through Texas’s State Continuation program.
State Continuation is similar to COBRA with a shorter time period. This state program allows you to continue on the company plan for nine months. You will need to pay the entire premium yourself since you won't be employed with us and would need to pay the salon by the 1st of each month for the upcoming month of coverage. The salon then passes your payment on to the insurance company.
You will get a packet in the mail from the insurance company 10-14 days after your last day of work, explaining the options above. It will include instructions for getting on the Marketplace website and an application for continuation of coverage through the state program along with instructions on where to mail or fax it. If you choose to go the State Continuation route, the coverage is retroactive back to your coverage end date, so there won't be any lapse in coverage, but you must pay all premiums due retroactively prior to receiving coverage. The only downside is that if you have a medical bill between the day your coverage ends and the date the State Continuation coverage is in place (typically 4 days after the application is received by the insurance company), you'd have to pay the entire bill out of pocket until you could get insurance reimbursement.
Individual policies available through the Marketplace don't typically include maternity, substance abuse, mental health, etc, that employer group plans do but they are less expensive.
The following link explains State Continuation https://www.tdi.texas.gov/hmo/documents/enrolleecobra.pdf There is also a telephone help line listed in that document if you have questions.