Health Insurance

Madison House currently provides individual health insurance for eligible part-time employees, who are scheduled to work a minimum of 30 hours per week, and for full-time employees. Healthcare benefits begin on the 1st of the month following the date of hire. Eligible employees may elect to participate in available health plan(s) offered by Madison House. Madison House presently pays 100% of the individual insurance premium for all eligible full-time employees and a prorated amount for part- time eligible employees. Madison House reserves the right to require employees to pay a portion of their insurance premiums in the future.

Employees can enroll dependents in their chosen health insurance plan. The monthly cost for the dependents will be deducted from the employee’s paycheck pre-tax.

Plan Choices

Madison House has three health insurance plans to choose from, review the summary of benefits to determine in what plan you wish to enroll:

1) Platinum

2) Gold

3) Silver

When enrolled in the Silver plan you will also be enrolled in the Health Equity Health Savings Plan (HSA). Madison House makes a monthly contribution into the HSA for enrolled employees.

Open Enrollment and Qualifying Life Events (QLE)

The plan year is December 1 through November 30 each year. You can change your plan during Open Enrollment in November or if you have experienced a QLE.

Examples of QLE

There are 4 basic types of qualifying life events. (The following are examples, not a full list.)

  • Loss of health coverage

    • Losing existing health coverage, including job-based, individual, and student plans

    • Losing eligibility for Medicare, Medicaid, or CHIP

    • Turning 26 and losing coverage through a parent’s plan

  • Changes in household

    • Getting married or divorced

    • Having a baby or adopting a child

    • Death in the family

  • Changes in residence

    • Moving to a different ZIP code or county

    • A student moving to or from the place they attend school

    • A seasonal worker moving to or from the place they both live and work

    • Moving to or from a shelter or other transitional housing

  • Other qualifying events

    • Changes in your income that affect the coverage you qualify for

    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

    • Becoming a U.S. citizen

    • Leaving incarceration (jail or prison)

    • AmeriCorps members starting or ending their service

Opting out of Madison House Insurance

If you are an eligible employee with coverage through a separate health insurance plan that complies with the requirements of the Affordable Care Act, you may choose to decline group health insurance provided by Madison House. If you decline coverage you will receive a payment equal to 25% of your monthly employee-only premium cost each month. Payments will be made each pay period and treated as regular taxable income. This benefit is in no way intended to incentivize you to decline health insurance coverage. To claim this benefit, you must first fill out and return the Waiver of Group Health Benefits and return it to the Business Manager.

Leaving Madison House

Your health insurance coverage will end on the last date of the month of your final day of work. Employees enrolled in Madison House group health coverage may elect to pay for state continuation coverage to remain under Madison House’s group health coverage for up to twelve months.