Who is an Eligible Employee?

• Only active, regular, full-time employees and owners (such as proprietors and partners) are considered Eligible Employees. Seasonal/temporary employees and 1099 employees are not eligible.
• Employees must work a minimum of either 20 or 30 hours per week to be considered full-time. Please refer to your most recent Renewal Packet or contact Banyan Administrators to confirm your company’s minimum hourly requirement for employees.

(Note: Employees must work 30 hours to be eligible for Life or LTD)

What forms need to be completed?

• Only the employee may fill in, or modify, information on the Employee Enrollment Form. Any changes to information must be initialed and dated by the employee. No alteration to preprinted material on the Employee Application is acceptable, and altered forms will be rejected.
• Provide the appropriate form(s) to the employee, based on your firms offerings:
  • Medical with or without Dental and Vision
  • Form A1: Medical/Dental/Vision Enrollment Form
  • Dental and/or Vision
  • Form A2 Delta Dental and/or Vision Service Enrollment Form
  • Life and/or Long Term Disability
  • Form A3: Group Term Life-LTD Enrollment Form, and
  • Form A4: Group Life-LTD Health Statement (groups of 2-3 only)

When do forms need to be submitted to Banyan Administrators? 

• Enrollment forms must be submitted to Banyan Administrators within 31 days of the Coverage Effective Date.
• The Coverage Effective Date is Determined by:
  • Date of Hire: The date a permanent employee begins working full-time.
  • Waiting Period: Refer to your most recent Renewal Packet or contact Banyan Administrators.
  • First of the month following Date of Hire, or
  • First of the month following 30 days of employment, or
  • First of the month following 60 days of employment
• Example: A firm has a 30 day waiting period and hires an employee on July 7th. The Coverage Effective Date would be September 1st and the forms must be submitted by October 1st.
• If the Date of Hire is the first of the month, and the group has a Date of Hire waiting period, coverage will be effective on that date.
  • Example: An employee hired July 1st would have coverage effective July 1st. An employee hired July 2nd would have coverage effective August 1st.
• If the form is not submitted within 31 days, the employee cannot enroll until the next Open Enrollment period, or until they have a qualifying life event.

What if an Eligible Employee does not want to enroll?

• Are they enrolled in another group health plan?
  • If yes, the waiver is considered valid.
  • The employee should complete the Coverage Declination section of the Enrollment Form for your records.
  • If no, the waiver is invalid and affects your compliance with the Employee Participation requirement.
  • At least 75% of eligible employees without valid waivers must enroll in Medical.
  • 100% of eligible employees without valid waivers must enroll in Dental/Vision.
  • Employees working 30 or more hours cannot waive Life or LTD.