Required Notices
Please read these important notices regarding your benefits:
- Continuation of Benefits (COBRA)
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Should you leave Rice for reasons other than “gross misconduct” and not qualify as a retiree, or if your spouse or dependent has a qualifying event, you have the option to continue medical and dental benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA) for a limited period of time.
If you are entitled to COBRA benefits, Rice will give you a notice stating your right to choose to continue the benefits provided by the plan. You have 60 days to accept coverage or lose all rights to benefits. Once COBRA coverage is chosen, you are required to pay for 102 percent of the cost of coverage.
Rice University treats domestic partners as spouses for purposes of COBRA coverage under the Rice medical and dental plans. Please contact human resources should you, your spouse or domestic partner, or your dependent become eligible for COBRA coverage or if your dependent should no longer qualify for coverage.
The following chart details the length of time you or your dependent will be entitled to COBRA benefits:
Qualifying Event Beneficiary Coverage Termination or reduced hours Employee 18 months Spouse 18 months Dependent Child 18 months Divorce or legal separation Spouse 36 months Dependent Child 36 months Death of covered employee Spouse 36 months Dependent Child 36 months Loss of “dependent child” status Dependent Child 36 months - Special Enrollment Rights
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If you decline enrollment for yourself or your dependents (including your spouse) under a Rice medical or dental plan because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents, provided that you request enrollment within 30 days after your other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
- Genetic Information Nondiscrimination Act (GINA)
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GINA — Genetic Information Nondiscrimination Act of 2008 — expands the genetic information protections included under HIPAA. HIPAA prevents the Rice medical plans from imposing a pre-existing condition exclusion provision based solely on genetic information and prohibits discrimination in individual eligibility, benefits, or premiums based on any health factor (including genetic information). GINA provides that group health plans cannot base premiums for a group of similarly situated individuals on genetic information. (However, premiums may be increased for the group based upon the manifestation of a disease or disorder of an individual enrolled in the plan.) GINA also generally prohibits group health plans from requesting or requiring you to undergo a genetic test. However, your healthcare provider is permitted to request a genetic test. Additionally, genetic testing information may be requested to determine payment of a claim for benefits, although GINA limits the scope of the request to only the minimum amount of information necessary in order to determine payment. There is also a research exception that permits a plan or issuer to request (but not require) that you undergo a genetic test. GINA also prohibits group health plans from collecting genetic information (including family medical history) prior to or in connection with enrollment. Thus, under GINA, group health plans are generally prohibited from offering rewards in return for the collection of genetic information, including family medical history information collected as part of a Health Risk Assessment. An exception is included for incidental collection, provided the information is not used prior to or in connection with enrollment. However, this exception is not available if it is reasonable for group health plans to anticipate that health information will be received in response to a collection unless the collection explicitly states that genetic information should not be provided.
- Medicaid and Children’s Health Insurance Program (CHIP)
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Medicaid and Children's Health Insurance Program (CHIP) Notice
- Protection From Loss of Medical Coverage
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Another federal law called HIPAA — the Health Insurance Portability and Accountability Act — protects you from loss of medical coverage if you change jobs. Your new employer’s plan cannot deny or postpone coverage for “pre-existing conditions” before notifying you, in writing, of: (1) the existence and terms of any pre-existing condition exclusion under the plan and (2) your right to demonstrate creditable coverage (and any applicable waiting periods).
A certificate of group health coverage will be provided when you or a dependent loses coverage under a Rice medical plan. You may need this certificate for your new group or individual plan to provide evidence of your prior coverage.
- Women’s Health and Cancer Rights Act of 1998
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Because the Rice medical plans provide medical and surgical benefits in connection with a mastectomy, the university’s medical plans also will provide benefits for certain reconstructive surgery. In particular, the plans will provide, to a participant or beneficiary who is receiving (or presents a claim to receive) benefits in connection with a mastectomy and who elects breast reconstruction in connection with such mastectomy, coverage for the following:
- reconstruction of the breast on which the mastectomy has been performed.
- surgery and reconstruction of the other breast to produce a symmetrical appearance.
- prostheses and physical complications associated with all stages of mastectomy, including lymphedemas, in a manner determined in consultation between the attending physician and the patient.
To the extent permitted by applicable law, this coverage may also be subject to benefit maximums and copayment provisions that may apply under the plans. You should review the provisions of your plan regarding any such restrictions that may apply.
If you have any questions regarding this coverage, please contact human resources.
- Newborns’ and Mothers’ Health Protection Act
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Federal law generally prohibits restricting benefits for hospital lengths of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery and less than 96 hours following a cesarean section. However, federal law does not generally prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, the Rice medical plans may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). However, to use certain providers or facilities or to reduce your out-of-pocket costs, you may be required to obtain precertification.
- Qualified Medical Child Support Order
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If you are enrolled in a Rice medical plan and you are required under a “qualified medical child support order” (as that term is defined under ERISA) to provide coverage for a minor dependent child, you may enroll such minor dependent child included in the order at any time following the date on which the order was signed by a competent court or administrative agency. Rice University will determine whether an order is a qualified medical child support order and whether such child is eligible for coverage under the qualified medical child support order.
- Continuing Health Coverage During a Military Leave(USERRA Rights)
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In accordance with the Uniformed Services Employment and Reemployment Rights Act (USERRA), if you are called into military service (active duty or inactive duty training), you may continue coverage under the Rice medical and dental plans during a USERRA leave as long as you continue to make the required contributions. Generally, you may continue your coverage through the 18-month period beginning on the date on which your USERRA leave begins or through the period ending on the day after the date on which you fail to return to a position of employment with Rice University, as determined in accordance with USERRA, whichever ends earlier. If your USERRA leave is 31 days or longer, you may be required to pay up to 102 percent of the required contributions. If the USERRA leave is for less than 31 days, your required contributions will remain the same as similarly situated active employees. Note that coverage provided under USERRA will run concurrently with any right-to-continue coverage under COBRA.
To be eligible for USERRA benefits, you are generally required to give advance notice of your military leave to human resources. For more information about continuing coverage under USERRA, contact human resources.
- Notice of Privacy Practices
- Medicare Part D Notice of Creditable Coverage
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All of Rice's medical plans provide creditable coverage for when you transition to Medicare Part D (the prescription drug component of Medicare). Here is the link to the documentation for the July 1, 2024 - June 30, 2025 plan year.
- Notice of Privacy Practices
The 2022 Summary Annual Report is also available for your review.
If you have any questions about any of these resources, please contact benefits@rice.edu or call (713) 348-2363.