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Coverage

When Coverage Begins

The date coverage begins depends on whether the participant is a new employee or is currently enrolled.

  • Pre-existing condition clauses do not apply to any of Leidos' medical plans.
  • Refer to the Dental Plan section of this site for information on the dental plan exclusions. Additionally, the individual dental carriers should be contacted for information on the specific exclusions for dental work in progress.
  • Review Life and LTD plan types for language describing pre-existing conditions and exclusions.

New Employees

Newly hired employees must enroll within 31 days of the date they become eligible. Upon hire, the employee will receive a package of enrollment materials, including instructions on how to enroll. The effective date of coverage is the employee's date of hire. If the participant is disabled and away from work on the date coverage would begin, coverage will take effect on the day the participant returns to work. Coverage for enrolled dependents will take effect on the same date as the participant's coverage start date or as of the date the dependent becomes eligible for coverage.

Changes may not be made to benefit elections until the following Open Enrollment period unless a qualified life event occurs. Coverage changes are generally effective on the date of the qualified life event. Please see Changing Coverage (Qualified Life Event Changes).

Current Employees

An Open Enrollment period is held every fall, during which all eligible employees can enroll in, change or drop coverage. Changes are effective on January 1 following the Open Enrollment period. Information, including instructions on how to enroll, will be provided during the Open Enrollment period each year.

Changing Coverage

Qualified Life Event Changes

Because contributions for most benefits are deducted on a pre-tax basis, IRS regulations require that a participant, once enrolled, may not change his or her election until the next Open Enrollment period unless a qualified life event occurs.

Experiencing a qualified life event allows a participant to change the level of coverage (but not to switch plans) within 31 days of the event. Qualified live event changes include, but are not limited to:

  • Adding a dependent through marriage, registered domestic partnership, birth, adoption or legal guardianship;
  • Losing a dependent through legal separation, annulment, divorce, dissolving of a registered domestic partnership or death;
  • Dependent's loss of eligibility by attaining age 26*;
  • Loss of other health insurance for a Leidos employee, the spouse or registered domestic partner and/or dependent child(ren) of a Leidos employee who loses coverage through the employer of a spouse or registered domestic partner (for example, other coverage lost due to layoff, termination, disability, severance, substantial reduction in benefits or reduction in work hours);
  • Gaining eligibility for other coverage through a spouse's or registered domestic partner's plan, COBRA or Medicare (or MediCal in California);
  • Receiving a court order — a Qualified Medical Child Support Order (QMCSO) — requiring the addition of medical coverage for children not in the participant's custody;
  • Changing residence and thereby affecting access to a plan service area; and
  • Changing child or adult care situations, such as providers or costs

 

important information

Benefit Change Must be Consistent with Qualified Life Event 

Any changes made outside of the Open Enrollment period must be consistent with the qualified life event. The participant may add a spouse as a dependent, for example, after a marriage, but may not change from one plan to another. A qualified life event change does not occur when a participant's provider leaves a plan or network.

Participants must update their enrollment in Workday within 31 days of a qualified life event. for questions about enrollment, contact Employee Services at 855-553-4367, option 3 or via email at [email protected].

Cost of Coverage

Contribution rates are reviewed annually and adjusted as necessary, generally at the beginning of the new year.

Leidos and the participant share the cost of benefit coverage. Leidos pays a large percentage of the cost for most benefits. As part of the enrollment process, participants authorize Leidos to deduct their share of the cost (premiums) for applicable benefits from their pay. The amount of the contribution depends on the benefit election. 

How Pre-tax Premium Contributions Affect Take-Home Pay

Premiums for certain Leidos benefits are deducted from a participant's pay before Social Security taxes and federal, state, and local (where applicable) income taxes are deducted. Paying premiums before taxes are taken out reduces the amount of gross salary. This lowers taxable income and, therefore, lowers the amount of payable income tax.

In exchange for lowering a participant's taxable income, the IRS restricts his or her ability to change coverage during the year unless the participant or dependent experiences a qualified life event or changes coverage during an Open Enrollment period.

When Coverage Ends

Coverage for most benefits will end as of the last day of the pay period for:

  • Termination of employment*;
  • Failure to pay required premiums;
  • Commencement of a leave of absence;
  • Loss of eligibility status; or
  • Strike**

In the case where the participant is still covered but the dependent loses eligibility, coverage for dependents end on the date they no longer meet the definition of dependent under Leidos' plan.

If the participant is divorcing, or is granted a legal separation, coverage for the spouse ends on the day the divorce is final or the effective date of the legal separation. If dissolving a registered domestic partnership, coverage for the registered domestic partner ends on the date reflected as the Termination of Domestic Partnership.

Coverage for children ends on the last day of the month of their 26th birthday.

Coverage for a permanently disabled child continues as long as the child qualifies as a disabled dependent as determined by the plan. Periodic proof of continued disability (generally once every 24 months) will be required.

*If a participant’s disability started prior to termination of employment, disability benefits will continue to be paid up to the maximum duration approved under the plan.

** For collectively bargained participants, disability benefits will continue to be paid if a strike occurs and the disability started prior to the strike. Benefits will be paid up to the maximum duration approved under the plan.

Federal law and Leidos policy determine eligibility for family and medical leave. Eligible employees may take up to 12 weeks of unpaid family and medical leave. Leidos will continue health care coverage for a participant and covered dependents while the participant is on approved family or medical leave unless the participant elects to suspend coverage during the leave. If continued coverage is elected, the participant is responsible for the same contribution paid while working. If suspension of coverage is elected, the same elections in effect prior to the leave will be reinstated when the participant returns to work, unless the participant experiences a qualified life event change.

Continuing Coverage After Plan Ends

A federal law called the Consolidated Omnibus Budget Reconciliation Act (COBRA) enables a participant and any covered dependents to continue health insurance if their coverage ends due to a reduction of work hours or termination of employment (other than for gross misconduct). Federal law also enables a participant's dependents to continue health insurance if their coverage stops due to the participant's death or entitlement to Medicare; divorce; legal separation; dissolution of domestic partnership; or when the child no longer qualifies as an eligible dependent. The participant must elect coverage according to the rules of the Leidos health care plans. Continuation is subject to federal law, regulations, and interpretations.

In accordance with COBRA, a participant and covered family have some important rights concerning the continuation of group health care benefits if that coverage ceases.

Participants that lose health coverage as a result of an Open Enrollment action will not be eligible to continue coverage under COBRA.