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
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.
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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.
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If a participant is totally disabled and the disability continues for more than 180 days, disability benefits may continue but medical, dental and/or vision coverage under the active group plan will end. Participants may choose to continue coverage at their own expense under COBRA. Under certain circumstances, the participant may participate in the Health Care Flexible Spending Account — on an after-tax basis — under COBRA.
If an employee's disability extends beyond 180 days, life insurance benefits will continue until the earliest of the following dates:
- The date the employee is no longer disabled;
- The date the maximum benefit period ends:
- For Basic Term Life Insurance, the maximum benefit period is 24 months from the commencement of long-term disability benefits;
- For Basic Dependent Life Insurance, the maximum benefit period is 24 months from the commencement of long-term disability benefits;
- For Group Universal Life Insurance, coverage ends on the date placed disability. Continuation of coverage may be available through Prudential;
- The day after the period for which premiums are paid.
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If a participant is on a military leave of absence, he or she is eligible to elect COBRA continuation coverage.
COBRA coverage may continue for 24 months or until the day after the participant fails to return to work after the end of the leave, whichever is sooner. Coverage will also end if the participant fails to make any required contributions on a timely basis. See "Continuing Health Care Coverage Through COBRA"; in the Plan Information section.
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Rehires
If a participant terminates employment and is rehired within 30 days, prior elections are reinstated unless another event has occurred that allows a change. A participant that is rehired after 30 days will be treated as a new employee and may make new elections – see “New Employees” section.
Return from Leave of Absence
If a participant returns to work after a leave of absence, and coverage ended during the absence, coverage will be reinstated on the first day the participant returns to active work in an eligible status. If the participant is returning to work in a new plan year, new benefit elections may be required for certain plans, such as the Health Savings Account (HSA), Flexible Spending Accounts (FSA) and Group Universal Life (GUL) Cash Accumulation Fund (CAF).
Continuing Coverage After Plan Ends
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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.
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Who Is Eligible For COBRA
- A covered participant who loses coverage due to termination (other than termination for gross misconduct) or reduction in work hours. Termination includes voluntarily quitting, layoff, and lack of work due to a work location closure.
- The spouse, registered domestic partner and/or dependent children of a covered participant who are covered under the plan and who lose coverage as a result of any of the following qualifying events:
- The death of a covered employee;
- The termination of a covered employee (excluding termination due to gross misconduct);
- The divorce, legal separation, or dissolution of a domestic partnership of the covered employee from his or her spouse or domestic partner;
- A dependent's ceasing to qualify as a "dependent child" under the terms of the plan; or
- The covered employee's becoming entitled to Medicare benefits
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How to Continue Coverage Through COBRA
To continue coverage, it is the participant's (or a family member's) responsibility to update Workday or notify Employee Services within 31 days of a divorce, legal separation, dissolution of domestic partnership, or a child losing dependent status.
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When Will COBRA Coverage End
The coverage period begins on the date of the qualifying event and ends upon the earliest of the following:
- 18 months in the case of termination of employment, layoff, or work force reduction;
- 24 months in the case of military leave of absence;
- 29 months in the event of a disability, according to Social Security;
- 36 months in the event of legal separation, divorce; dissolution of domestic partnership or death of the employee;
- 36 months in the event of all other qualifying events;
- Failure to pay any required premium when due;
- The date a covered participant, under the continuation program, becomes covered under another group plan or Medicare — one that does not impose any pre-existing condition limitations on the coverage; or
- The date that Leidos no longer provides a group medical plan to any of its employees
The participant must apply for this coverage continuation within 60 days from the date the participant's Leidos medical coverage terminates or the date of notification, whichever is later. The participant then has 45 days from the date he or she elected continued coverage to pay all of the premiums back to the date he or she would have lost plan coverage. The participant will be charged the plan's full cost of providing continued coverage, plus an additional 2% administrative fee (102% of the premium). If the participant wants to continue coverage through COBRA, please contact the number indicated on the notification letter, or, if eligible due to divorce, legal separation, dissolution of domestic partnership, or loss of dependent status, contact Employee Services for more information.
Disability
To be eligible for the additional 11 months of coverage due to disability, the participant must provide the Plan Administrator with: a Social Security Disability Award (SSDI) during the first 18 months of COBRA indicating the onset of the disability was within 60 days of losing coverage; and the Plan Administrator is informed of that within 60 days of receipt of the Notice of Award letter from Social Security by receiving a copy of that letter. A participant who qualifies for the disability extension will be charged the plan's full cost of providing continued coverage, plus an additional 50% administrative fee (150% of the premium).
Second Qualifying Life Events
If a current COBRA covered participant experiences a second qualifying life event during the initial 18- or 29-month COBRA coverage period, the covered spouse/domestic partner and/or dependent children may receive up to a maximum of 36 months of coverage from the initial qualifying event date. A participant will only be entitled to an extension if the same event would have caused a loss of coverage under the Plan if it were the original event. The extension may be available to the covered spouse/domestic partner and /or dependent children for one of the following reasons:
- divorce or legal separation from the covered employee; or
- the dependent child no longer meets the definition of a “dependent” according to the terms of the Plan(s); or
- the death of a covered employee.
You must notify the COBRA administrator of the second qualifying event within 60 days of the event. You will not be entitled to the extension if you fail to provide timely notice.