Frequently Asked Questions
What is a Project-Based employee?
A Project-Based employee is a production worker who is hired for a discrete project, or projects, and whose employment relationship is expected to end upon completion of the project(s).
What is a Staff employee?
A Staff employee is an employee who is not expected to terminate upon completion of a specific project. To be considered a Staff employee, your employer must identify you as such.
I work through a loan-out corporation. Am I eligible to participate in Open Health?
In most cases, yes! Please check with your employer as there are exceptions.
How do I know if my employer is a member of Open Health?
If your employer is a member employer of Open Health, you should receive a memo when you begin employment. If you don’t receive the memo, please ask your employer if they are a member employer of Open Health.
If my employer uses Cast & Crew for payroll, do my hours automatically count?
An employer group may use Cast & Crew for payroll, but may not necessarily be a member employer of Cast & Crew Open Health. Likewise, an employer group might be a member employer of Cast & Crew Open Health, but is not required to use Cast & Crew for payroll services. In order for your hours to count toward eligibility, your employer must be an active member employer of Cast & Crew Open Health.
What is an Initial Employment Period (IEP)?
The Initial Employment Period is the period during which an employee initially enters the plan. This can occur when the employee first begins working for a member employer of Open Health; or when the employee’s current employer becomes an employer member. The Initial Employment Period will continue until the employee has been a plan participant for a full Measurement Period. Note: A continuing employee will be considered a new participant and will begin a new Initial Employment Period the day the employee again works for a member employer after 22 consecutive weeks of payroll inactivity.
How does a Project-Based employee become eligible for coverage?
To qualify for coverage, an employee must successfully complete a Qualifying Month. A Qualifying Month consists of pay periods ending on Saturdays (4 or 5 weeks) within a calendar month. An employee who works a minimum of 130 hours in a Qualifying Month during the Initial Employment Period (IEP) becomes eligible for coverage. Coverage takes effect the 1st of the month following a 2-month waiting period. For example, if the hours are met during the month of January, coverage will take effect April 1st. Continuing eligibility will be determined based on hours worked during set measurement periods throughout the year.
When does coverage terminate?
Coverage terminates when we see a consecutive 9-week lapse in payroll activity during the Initial Employment Period. Coverage will terminate the last day of the month in which the 9th week occurs.
What is a Measurement Period?
Open Health has two (2) six-month Measurement Periods every year: November through April; and May through October. An employee must average a minimum of 30 hours per week during a Measurement Period to qualify for the subsequent Stability Period.
What is a Stability Period?
If the hours requirement is met during a Measurement Period, an employee will qualify for the 6-month Stability Period. The Stability Period begins two (2) months after the Measurement Period ends. There are two Stability Periods in a calendar year: January 1 through June 30; and July 1 through December 31. If an employee qualifies for a Stability Period, coverage will remain stable even if the employee is no longer employed.
I am a Project-Based employee who works for more than one employer. Will all of my hours count?
All hours worked for member employers will count toward your Open Health eligibility.
How will I know when I’ve qualified for coverage?
When you qualify for coverage, a Welcome Packet will be sent directly to your home address with detailed information and enrollment instructions. This information will also be sent via email if we have an email address on file.
What type of coverage will I be offered?
The coverage you’re offered will be based on your state of residence and your status as either a Project-Based or Staff employee.
How much will my coverage cost?
The standard employee-only medical coverage provided to you is 100% employer-paid. The standard plan will vary based on your state of residence.
Are there additional coverage options?
Yes, all eligible employees have the option to purchase different medical plans and a dental/vision/life bundle. Eligible employees may also add qualified dependents to the elected lines of coverage.
I am a Project-Based employee and have qualified for coverage. How long will I remain insured?
If you qualify for coverage during your Initial Employment Period, coverage will remain active unless/until we see a consecutive 9-week lapse in payroll activity. Coverage would then terminate the last day of the month in which the 9th week occurs. If you maintain your coverage during the Ongoing Employment Period, and meet the hours requirement during a Measurement Period, coverage will be guaranteed through the subsequent Stability Period.
What if I had coverage during my Initial Employment Period, but coverage terminated due to a consecutive 9-week payroll lapse. How do I regain coverage?
If you are still within your Initial Employment Period, you will qualify for coverage the 1st of the month following your next reported payroll activity.
What happens if I return to work for a member employer after a long absence?
If you return to work after an absence of at least 22 consecutive weeks, you will be considered a new hire and must re-qualify for coverage by working a minimum of 130 hours in a Qualifying Month.
I’m a Project-Based employee and currently have coverage through Open Health. What happens if I start a project for a new employer?
Your Open Health coverage is portable among member employers. If your new employer is a member of Open Health, your hours will count toward maintaining your coverage.
May I contact Open Health directly with additional questions?
Yes, Open Health may be reached Monday through Friday during regular business hours to answer all of your questions. We can be reached by phone at (866) 491-4001 or by email at firstname.lastname@example.org.