Enrollment Kit

Frequently Asked Questions

How Do I Enroll For Coverage?
Who Is Eligible For Coverage?
Can I Sign Up For Coverage At Any Time?
When Does Coverage Begin?
When Will My Coverage End?
Are There Any Pre-Existing Limitations?
Should I Buy TransChoice If I Already Have Group Medical Insurance?


How Do I Enroll For Coverage?
You may enroll for your benefits when you first become eligible (as defined by your employer) or during one of your employer’s annual open enrollment periods, by completing an enrollment form and returning it to your benefits enroller.

Who Is Eligible For Coverage?
All actively-at-work employees working a minimum number of hours per week are eligible (as defined by your employer). Dependent coverage is available to a legally married spouse* and any unmarried children or stepchildren, under age 19, who are living with the insured or for whom you are legally required to provide support. Full-time students going to an accredited school and under age 24, are also eligible for coverage. Refer to the policy for a complete list of requirements for eligibility.

Can I Sign Up For Coverage At Any Time?
No. If you do not enroll during your eligibility period, you cannot enroll until your employer’s next annual benefit enrollment period. You may add dependent coverage when you enroll, during an annual enrollment period, or within 31 days of the date a dependent becomes eligible for coverage.

When Does Coverage Begin?
Coverage will be effective on the first of the month following approval of your enrollment form and receipt of your first premium, provided you are actively at work at that time. “Actively At Work” means that you are performing in the usual manner all of the regular duties of your employment on a scheduled work day and these duties are being done at one of the places of business where you normally do such duties or at some location to which your employment sends you.

Coverage is not effective on the date of your application. The effective date for your eligible dependents will be the same as yours (unless dependent coverage is added at a later time). However, if any dependent is totally disabled on his or her effective date, the coverage of that dependent will be deferred until the dependent ceases to be disabled. A dependent is totally disabled if unable to perform a majority of the normal activities of a person of like age in good health.

When Will My Coverage End?
For you, coverage will end when you no longer qualify as an eligible insured, or when your premium payments are discontinued, whichever occurs first. Coverage on a dependent ends on the earlier of the date that he or she no longer meets the definition of a dependent, premium payments are discontinued or the date that your coverage terminates. Coverage for you and your dependents will end when the employer’s coverage under the group master policy terminates.

Are There Any Pre-Existing Limitations?
TransChoice does not exclude benefits for pre-existing conditions for any benefits except for the Critical Illness Coverage. For this coverage, TransChoice does not provide coverage during the first 12 months your coverage is in force for any disease, sickness, or physical condition for which symptoms existed that would cause a person to seek diagnosis or for which you had treatment, incurred expense, took medication or received diagnosis or advice from a physician during the 12-month period from the effective date of your coverage.

Should I Buy TransChoice If I Already Have Group Medical Insurance?
If you, your spouse or your dependents are covered under any group medical plan, the benefits paid under this plan may affect the benefits paid by the other plan.

*Spouse or equivalent as defined by governing state law.