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Eligibility

Enrolling in benefits

When enrolling in your benefits, it’s important to know:

  1. When you can enroll AND
  2. Whom you can enroll

Below, you’ll find information on allowed enrollment windows and eligibility for yourself and your dependents.

Questions?

If you have questions, please contact HRHub at HRHub@childrens.harvard.edu or 617-355-7780, x 57780.

Eligibility

You and your dependents are eligible for Boston Children’s benefits if you meet the following criteria

Your eligibility

You are eligible for Boston Children’s benefits if you are a full-time or part-time employee regularly scheduled to work 20 or more hours per week, and you are not classified as a temporary or per diem employee. Your coverage begins on your date of hire or initial eligibility date.

Your dependents eligibility

For Boston Children’s Medical, Dental, Vision, and Life Insurance plans, your eligible dependents include:

  • Your legally married spouse (as defined by the Federal IRS tax code)
  • Your children up to age 26 who are your biological children and children for whom you are the legal guardian regardless of financial dependency, marital status, student status, or residency
  • Your unmarried, disabled children over age 26 with mental or physical disabilities who are dependent on you for primary financial support and maintenance. Their disability must have existed before age 19 and they must be incapable of self-support.

Eligible dependent children include:

  • Your biological children
  • Your adopted children
  • Your stepchildren
  • Your foster children
  • Children of your spouse
  • Children for whom you are the legal guardian
  • Dependent children of a married or unmarried eligible dependent

Domestic partners and children of domestic partners are not eligible.

Dependent Verification Documentation

To ensure that we are covering only those dependents who meet our plans’ eligibility requirements, Boston Children’s may ask you to provide documentation to support dependent eligibility. Documentation may include a birth/adoption certificate, a marriage certificate, evidence of disability, or other documents establishing dependent eligibility.

Falsifying, omitting, or misstating dependent information may be grounds for disciplinary action. If a dependent does not meet the legal or contractual definitions, then all benefits will be denied to those individuals, and the employee will be responsible for any health care costs paid by Boston Children’s.

Enrolling in and Making Changes to Your Benefits

If you’re benefits-eligible, you can enroll in or make changes to your benefits during these times:

  • Within 30 days of your hire date or becoming newly eligible
  • During Boston Children’s annual Open Enrollment
  • Within 30 days of a qualified change in your family or job status

Because of IRS rules around pre-tax benefits, if you miss the 30-day window after becoming eligible, you’ll have to wait until the next Open Enrollment — unless you have a Qualifying Life Event.

You’ll get access to the New Employee Portal, (password BCH321) before your start date. The New Employee Portal provides plan details, costs, and instructions for enrolling online.

If you enroll in Medical, Dental, Vision, Life Insurance, Long Term Disability, or Legal coverage, or the Health Savings Account (HSA) or a Flexible Spending Account (FSA), your benefits begin on your hire date or eligibility date — as long as no evidence of insurability (EOI) is required. If EOI is needed, coverage starts once it’s approved by the insurance provider.

You must enroll in the following within 30 days of becoming eligible:

  • Medical, Dental, Vision
  • Supplemental Life Insurance (including Spouse/Child)
  • Long Term Disability
  • Voluntary Insurance
  • Legal Plan
  • Health Care Flexible Spending Accounts

Benefit deductions are based on the effective coverage date and are not prorated — you’ll be charged the full pay-period amount.

Outside your initial 30-day enrollment window, you can only make benefit changes during Open Enrollment or if you have a qualifying life event (also called a status change or referred to as a QLE).

Since Medical, Dental, Vision, and FSA contributions are pre-tax, the IRS limits when you can make changes.

What Counts as a Qualifying Event?

A qualifying change in status includes:

  • Marriage, divorce, or death of a spouse
  • Birth, adoption, or death of a dependent
  • Starting or ending a job for you, your spouse, or a dependent
  • Job schedule changes affecting your eligibility (e.g., full-time to part-time, unpaid leave)
  • Permanent address change that impacts your coverage (e.g., moving out of an HMO area)
  • Significant changes to your or your spouse’s non-Boston Children’s plan

Your changes will be effective as of the event date.

Important Reminders

  • Your benefit change must match the event. For example, if you get married, you can add your spouse to your plan — but you can’t make unrelated changes.
  • Coverage changes are effective as of the event date and are not prorated.
  • You must submit your request within 30 days of the event.

Make a Change

  1. Gather your information:
    • Type of Qualifying Event
    • Documentation (e.g., marriage certificate)
    • Date of the change
    • Coverage you want to update
  2. Log in to PeopleSoft with your Employee ID and password
    • Go to: Employee Self-Service Home > My Benefits Home > Benefits Details > Life Events, then follow the steps

Questions?

If you have questions, please contact HRHub at HRHub@childrens.harvard.edu or 617-355-7780, x 57780.