Welcome to the Wellness Family

The Group Health Insurance Unit manages and maintains medical, dental, and life insurance benefits for employees and retirees of the government.

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Medical and Dental Coverage Enrollment

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The Virgin Islands government offers to full-time employees and their eligible dependents, group health and dental insurance plan.

 

Full-time employees must enroll within thirty-one (31) days of hire unless they can provide proof of medical coverage from another source An employee who does not enroll within 31 days of employment will be automatically enrolled in the health insurance plan with single coverage.

 

If an employee fails to enroll dependents within the initial eligibility period he/she must wait until a period of “open enrollment” is announced or have a qualifying event as determined by the health insurance carrier to enroll dependents or make changes to their coverage.

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Effective Date of Coverage

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If you enroll on or before the 6th of the month, coverage will be effective on the first day of the first month following the receipt of enrollment forms. If enrolled on the 7th of the month or later, coverage will be effective on the first day of the second month. If enrollment forms received on the 7th of the month or later, coverage will be effective on the first day of the second month following the receipt of the enrollment forms.

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Dependent Coverage

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Dependents of eligible employees may participate in the Group Health and Dental Insurance Program according to the terms and conditions imposed by the Health Insurance Board of Trustees and/or the carrier. Eligible dependents are the employee’s:

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1. Legal spouse;

2. Natural children;

3. Adopted children; and

4. Stepchildren.

 

When a new dependent is acquired, you must enroll them within thirty-one (31) days after acquiring such dependent.

 

When enrolling a dependent, the following is required:

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1. Birth certificate.

2. Marriage certificate.

3. Adoption papers; and/or

4. Legal papers of appointment

Various other documents may be required to determine the eligibility of the dependents.

 

Cost of Coverage

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The GVI contributes toward the cost of Health Insurance for each employee enrolled under the Group Health Insurance Program. The GVI reserves the right to change the amount of the employee contribution when necessary for financial or other reasons.

 

Dental Insurance

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As a condition of participation, all employees must enroll in medical coverage to qualify for Dental Insurance.

 

Waiver or Discontinuation of Benefits

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An employee who waives coverage upon employment, or who drops out of the program must provide proof of medical coverage via another source and will be subjected to the eligibility requirements imposed by the carrier in order to re-enroll in the program. This provision also applies to dependents that are dropped from the plan.

 

Coverage discontinues on the last day of the month following a qualifying event on the date of an employee’s separation.

 

Within 30 days of employee separation, they are eligible for Cobra (Consolidated Omnibus Budget Reconciliation Act) coverage. The Group Insurance unit will forward the member's information directly to the Benefit outsource who is a third-party Administrator, that provides Cobra benefits. The employee is responsible for 100% of the cost plus a 2% administrative fee if they choose to accept the benefit.

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An employee may opt to decline coverage or discontinue coverage under the Group Health

 

Leave without Pay

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The GVI will maintain Group Health Insurance plan coverage for employees on leave without pay. This coverage will remain at the level and under the conditions for which coverage would have been provided if the employee had continued employment continuously for the duration of the leave. However, employees on leave must arrange to pay into the Group Health Insurance Fund the employee’s share of their health insurance premium to maintain coverage. Failure to make payment(s), will result in the coverage being terminated.

 

Retirement Benefits

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Retired employees and their dependents are eligible to continue to participate in the Group Health and Dental Insurance Program. Retirees must complete an enrollment application within 30 days of their retirement to maintain coverage. 

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Life Insurance

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The government provides a complimentary basic non-contributory $10,000 basic life insurance benefit for active employees. In order for the benefit to be effective, enrollment must be completed in the Bentek Eligibility System and must indicate a designated beneficiary.

 

Employees may also elect additional life insurance in either 1x, 2x, 3x or 4x base salary of $10,000, $15,000, $25,000, $50,000, $75,000, $100,000 or $150,000 amounts as a supplemental contributory coverage. The employee pays the cost of this additional insurance and may be required to submit evidence of insurability when increasing more than one increment.

 

Upon retirement, the basic life insurance will be reduced to $5,000. The maximum amount of life insurance a retiree can receive is $150,000.

 

Upon death the designated beneficiary will be eligible to receive the life insurance proceeds of the insurance participant, the Division must be notified of the death in order to initiate the claim process. Life insurance benefits are payable by the contracted insurance company and a subject to the limitations established by the insurance company.

 

Supplemental Insurance

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The GVI has several supplemental insurance plans that provide coverage over and above the regular medical, dental, and life insurance coverage.

 

These plans are voluntary and are not contributed to by the GVI. A list of the current supplemental insurance plans is available through the Group Health Insurance Unit. An employee who does not wish to enroll in medical coverage is eligible to enroll in supplemental insurance.

 

Employee Assistance Program (EAP) 

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The GVI will provide confidential and voluntary assistance through its Employee Assistance Program (EAP) to all employees and their family members who may be faced with dynamic challenges of financial concerns, legal issues, alcohol or drug problems, marital problems, illness of a family member, emotional worries, child care problems, etc. For the welfare of employees as well as effective business operations, the GVI encourages its employees to take advantage of this valuable benefit of employment with GVI.

 

Application

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Employees and their family members can refer themselves to the EAP. The program may be reached 24 hours a day on weekdays and weekends.

 

EAP counselors are available to meet with employees or family members to assess a problem and develop a plan for resolution. The counselors may suggest a referral to an outside resource, such as a therapist, Departmental resource, physician, treatment facility or other professional that would be appropriate to assist in resolving the problem or situation. Where an employee may be in need of information, a referral or suggestion may be made over the telephone. There is no charge for employees or their families to use the services of the EAP.

 

Participation in the EAP Program does not jeopardize job security or promotional opportunities. However, it does not excuse the employee from following GVI policies and procedures or meeting required standards for satisfactory job performance except where specific accommodations are required by law.

 

Time Away from Work

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Employees who want to visit the EAP during regular work hours must use sick, vacation or personal time after their first meeting. If illness is involved, compensatory, sick, and/or annual leave may be used for treatment or rehabilitation on the same basis that it is granted for other health problems.

 

Mandatory EAP meetings will be completed using administrative leave.

 

The EAP counselors will make every effort to coordinate referral for ongoing treatment with the employee's health insurance coverage as well as his/her ability to pay.

 

Mandatory EAP

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When an employee's job performance or attendance is unsatisfactory or there appears to be signs of other problems during the work day, the supervisor should counsel the employee in consultation with the human resources officer or designee. If the employee appears to be unable or unwilling to correct the situation, the employee may be referred to the EAP to assist in the resolution of the problem. Depending on the situation, the employee may accept or refuse participation in the EAP. However, there may be situations where continued employment with the GVI may be contingent upon the employee calling the EAP for assistance.

 

REMINDER: All contact between an employee and the EAP is held strictly confidential. In cases where an employee's continued employment is contingent upon calling the EAP, the EAP counselor will only verify whether or not the employee has contacted the EAP, if ongoing treatment is necessary, and that the employee is following through on the treatment.