You are eligible for healthcare coverage when you work 80 hours or more a month, 2 months in a row and continue to work 80 or more hours a month to stay covered.

To get Coverage for Kids, you must work 120 hours or more a month and continue to work 120 or more hours a month to keep it. If you are not currently working 120 hours or more but would like to get Coverage for Kids, complete a Health Benefits Application by your application deadline. Coverage for Kids will start when you start working 120 hours or more a month.

You can enroll eligible children (through their 26th birthday) in Coverage for Kids. Your eligibility is based on how many hours you work per month. When enrolling, you can choose:

• Full medical and dental coverage for $100 per month.
• Dental-only coverage for $10 per month.

If you choose to enroll your child(ren), you will need to apply for benefits during an allowed enrollment window along with dependent verification documentation.

Learn more about Coverage for Kids. 

Your coverage start date will vary depending on when you submit your completed Health Benefits Application and when you meet eligibility criteria.

When your completed application is received affects when your coverage will begin. You can submit your application online using Health: My Plan, or by mail or fax.

Example:

• If you work 80 hours in January, you will receive an application in late February or early March.
• If your completed application is received by March 15, coverage will begin in April.
• If your completed application is received between March 16 and March 31, coverage
  will begin in May.

If you are applying for the first time: 

If you meet eligibility criteria and your completed application is received on or before the 15th of the month, your coverage will begin on the 1st of the following month. If your application is received between the 16th and 31st of the month, your coverage will begin on the 1st of the month after the following month.

Example: 

• If an application is received between January 1 and January 15, coverage will begin February 1st.
• If an application is received between January 16 and January 31, coverage will begin on March 1.

During Open Enrollment (July 1 – 20 every year): 

Your application and changes must be received on or before July 20 to be processed for coverage beginning August 1.   If you have a Qualifying Life Event: To enroll or make changes because of a Qualifying Life Event, contact SEIU 775 Benefits Group within 30 days.

• Example:  If you have a child on January 1, you have until January 31 to contact SEIU 775 Benefits Group about enrolling yourself and/or your children.

Your children’s coverage will start after:

• You submit a completed application and dependent verification documentation within an allowed enrollment window.
• You work the number of hours matching your coverage election.
• Your monthly co-premium payment has been received.

If you fall below the hours required for your children’s coverage option or do not pay your co-premium, coverage for your children will be dropped.

Learn more about Coverage for Kids.

If you are enrolled in healthcare coverage, but fall below 80 hours in any month, you will lose your healthcare coverage.

• Example: If you do not work 80 hours in January, healthcare coverage will end in March (unless you decide to self-pay for COBRA coverage).

If you lose coverage because you do not work 80 hours one month, but work 80 or more hours the following month, you will be automatically re-enrolled in health coverage the following month. If you have a break in coverage for more than 12 months, you will need to re-establish initial eligibility and fill out a new application to return to the health plan.

If you fall below the required hours for your children’s coverage option in any month, your  children’s coverage will stop until your hours go back up.

• Example: If your child is enrolled in Coverage for Kids and you do not work at least 120 hours in January, coverage for your child will end on March 1.

Please note hours worked must be reported to your employer within 60 days of the date worked to be used in the calculation of your health benefits eligibility. Your employer will report your hours worked to SEIU 775 Benefits Group. If your hours are reported late, hours will be recorded but coverage may not be extended.

Example: Hours worked in January must be reported to your employer by March 31, and received by SEIU 775 Benefits Group from your employer no later than April 20 to ensure March coverage.

A Qualifying Life Event is a change in your life situation that can make you eligible for a 30-day Special Enrollment period, allowing you to enroll in health coverage outside the yearly Open Enrollment. The 30-day period begins at the time of your event and you must complete and submit your application within the 30-day time frame.

Life events that may qualify you for a QLE Special Enrollment Period:

• Legal separation.
• Divorce.
• Death.
• Termination of employment (losing your job).
• Losing hours, so that you are no longer eligible for coverage.
• No longer living in a coverage area; or
• Cessation of dependent status.
• The plan no longer offers benefits to the class of similarly situated individuals.
• Exhaustion of COBRA; or
• Failure to meet eligibility criteria for CHIP or Medicaid.
• Termination of employer contributions for employee’s or dependent’s other coverage (whether or not coverage is lost).
• Employees or dependents become eligible to receive premium assistance under CHIP or Medicaid programs.
• You get married to a new spouse or get a new dependent (child), through:
  • Marriage.
  • Birth.
  • Adoption or placement for adoption.

If you cannot work 80 hours or more this month to be eligible for healthcare coverage for caregivers, you may want to get other health insurance.

Through the Washington Health Plan Finder website, you can sign up for free or low-cost Washington Apple Health (Medicaid), or purchase a low-cost qualified health or dental plan.

If you are an Individual Provider (IP) and need more hours from another client to keep coverage, try Carina, a free job-matching website that helps you find more clients.