Health Programs for Rose Group employees
Independence Administrators, a division of The Blue Cross/Blue Shield network of providers
The Rose Group offers coverage in our Value Plan with prescription coverage through Express Scripts and vision coverage with Davis Vision to qualified hourly team members. Team members considered “full-time” (averaging 30+ hours) under the ACA guidelines will be offered employer-sponsored coverage each year they qualify. See below for details about how to qualify for coverage. For more details about the plan see the Summary of Benefits Coverage.
DISCLAIMER - The Rose Group offers ACA qualified coverage. If you choose to shop for coverage on
Healthcare.gov and have qualified for Rose Group medical coverage, you
will need to select yes your employer offers qualified coverage.
Help with the Health Exchanges
Get Insured provides information via WEB or PHONE about obtaining an insurance plan through governmental health exchanges.
In some situations, you may be entitled to a financial subsidy through the government if you are considered a part-time employee with less than 30 average hours a week over the measurement period.
Get Insured helps educate you on healthcare.gov coverages, costs, eligibility, answers your questions and also handles the enrollment on your behalf.
The Rose Group offers ACA qualified coverage to eligible associates. If you choose to shop for insurance on the healthcare.gov site, but have qualified for employer-sponsored coverage with The Rose Group, you will need to select “yes” your employer offers qualified coverage.
To contact Get Insured call them at: 866-602-8466 or you may click here for their website:
Limited Hospital Plan / Dental / Vision
If you are interested in adding, changing current coverage, or canceling supplemental products offered by Aetna, you may do so only during the annual open enrollment period which is held in November of each year for a January 1st effective date.
Call Aetna at 1-800-581-3358 for more information.
Get the power of Ready. Enroll in your benefits today!
Open Enrollment starts 11/11/2019. All elections through your Ceridian/Dayforce account must be complete by the enrollment period end date of 11/22/2019.
It's impossible to predict the unexpected — but you can be ready for it.
Insurance plans are underwritten by Aetna Life Insurance Company (Aetna). Insurance plans contain exclusions and limitations. Policy forms issued include: GR-23. GR-9/GR-9N, GR-29/GR-29N, GR96172, and/or GR96173.
Aetna currently offers Rose Group employees:
Limited Hospital Plan | Dental | Vision
If you have questions regarding your Rose Group insurance programs, costs, coverages, we have partnered with a company called Health Advocate to answer all of your questions. To contact Health Advocate call: 1-866-695-8622 or visit their website at:
Independence Administrators — Value Plan
Notice of eligibility and enrollment information is sent to associates; electronically on their Dayforce Employee Self-Service Site, a letter is mailed to the address associates provide and a copy of the letter is sent to their store location.
Coverage MUST be elected each year an associate qualifies; coverage does NOT “carry over” into a new plan year.
Frequently Asked Questions
All associates are measured at one year of consecutive service. This is called initial measurement (an 11-month measurement from the 1st of the month after hire to the last day of the month prior to their hire month anniversary.) If an associate average 30+ hours over the measurement period, then ACA qualified, employer-sponsored medical coverage will be offered during an enrollment period in their anniversary month, coverage effective the 1st of the following month.
On-Going Measurement (also known as Annual Open Enrollment): Associates with greater than 12 months of consecutive service, will be measured with a 12-month measurement from November of the prior year to November of the current year. If they average 30+ hours over the measurement period, ACA qualified, employer-sponsored coverage will be offered during the annual open enrollment, held in November each year for coverage effective January 1st.
Enrollment into medical coverage with Independence Administrators, Value plan is available exclusively online on your employee Dayforce Self-Service site. Make sure you know your login information. CLICK HERE to be directed to Dayforce Self Service Login.
No, unless you have a qualified life event (QLE) then you have 30 days from the QLE date to elect coverage (loss of coverage due to death, divorce, loss of job with qualifying coverage, marriage, birth of child (60 days from QLE))
If coverage is not elected during the designated enrollment period, the next opportunity for enrollment will be during the next annual open enrollment (next year) for coverage effective Jan 1, and only if your average hours meet the ACA threshold for full-time (average 30+ hours) during the applicable measurement period, or with a qualifying life event (QLE).
No, it is possible that an associate who measured an average of 30+ hours last year and was offered coverage under the ACA full-time guidelines, will not measure as full-time for this open enrollment. If this happens, and the associate elected medical coverage during open enrollment last year, their coverage will end 12/31, and COBRA offered.
Coverage MUST be elected each year an associate qualifies; it does NOT “carry over” into a new plan year.
Upon termination coverage ends at the end of the month then COBRA will be offered.
If you elect medical insurance it is for a full plan year ending 12/31. Employees who elect coverage at their initial measurement (mid-year) are in stability until the following ongoing enrollment after one year of coverage.
Plans are active from Jan 1 to Dec. 31st. Your employer-sponsored coverage ends only upon termination, or with a QLE that provides other qualified coverage.
Medical premiums are a payroll deduction only. If your paycheck does not cover your bi-weekly premium amount you need to contact your Human Resources department and mail your premiums to avoid termination of coverage due to non-payment. Associates are responsible for paying premiums on time.
Resources & Regulatory Notices
Group health plans that are subject to HIPAA's portability provisions must notify employees of the plan's special enrollment rules. Employees must be notified on or before they become eligible to enroll. To provide this notice a plan may use the model language or may draft its own language, as long as it is consistent with HIPAA's special enrollment rules.
The Women's Health and Cancer Rights Act requires group health plans and health insurance issuers to provide certain benefits relating to post-mastectomy surgery. A notice about these rights must be provided to a participant upon enrollment in the plan and thereafter on an annual basis. The enrollment notice and the annual notice have different content requirements. However, Mercer recommends providing the enrollment notice annually and in new hire materials instead of the annual notice.
The Newborns' and Mothers' Health Protection Act (NMHPA or Newborns Act) requires group health plans to provide hospital coverage for a newborn and a mother for a period of at least 48 hours following a normal vaginal delivery and 96 hours following cesarean delivery.
COBRA continuation coverage can become available to you when you would otherwise lose your group health coverage. It can also become available to other members of your family who are covered under the Plan when they would otherwise lose their group health coverage.
The purpose of this notice is to advise you that the prescription drug coverage listed below under The Rose Group medical/Rx plans are expected to payout, on average, at least as much as the standard Medicare prescription drug coverage will pay. This is known as “creditable coverage.”
Why this is important. If you or your covered dependent(s) are enrolled in any prescription drug coverage during the year listed in this notice and are or become covered by Medicare, you may decide to enroll in a Medicare prescription drug plan later and not be subject to a late enrollment penalty – as long as you had creditable coverage within 63 days of your Medicare prescription drug plan enrollment. You should keep this notice with your important records. If you or your family members aren’t currently covered by Medicare and won’t become covered by Medicare in the next 12 months, this notice doesn’t apply to you. This notice is updated each year in October for the coming plan year.
The federal Children's Health Insurance Program (CHIP) includes premium assistance provisions that allow states to use CHIP funds to pay the cost of an eligible child's employer-sponsored group health plan coverage (and in some instances, eligible adults). It provides general information about premium assistance and special enrollment and includes federal and state-specific contact and website information for the 40 states that currently have these programs.
USERRA protects the job rights of individuals who voluntarily or involuntarily leave employment positions to undertake military service or certain types of service in the National Disaster Medical System. USERRA also prohibits employers from discriminating against past and present members of the uniformed services, and applicants to the uniformed services.
Since 2014 there is a new way to buy health insurance. To assist you as you evaluate your and your family options, this notice give some basic answers and directs you to references to review to make your choice.
Associates have available to them based on predetermined criteria the Value Plan. The information in this notice provides the details and definitions of that plan's offering.
This is a summary of the annual report that has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).