Learn Who is Eligible for Benefits

Eligibility


Requirements for eligibility include: 

  • Employee: Must be an Academic or Medical Center salaried employee of UVA, full- or part-time, and regularly scheduled to work at least 20 hours/week

    • J1 visa holders are only eligible for the UVA J1 Visa Health Plan option. Federal government regulations prohibit J1 visa holders from enrolling in the Basic, Value or Choice Health options.

  • Spouses:

    • For the UVA Health Plan: Must be legally recognized as spouses in the Commonwealth of Virginia and have no access to Affordable Healthcare Coverage of minimum value (as defined by the Affordable Care Act) through their non-UVA employers

    • For UVA Dental and Davis Vision: Must be legally recognized as spouses in the Commonwealth of Virginia

  • Children: Must be your biological, step, adopted, or foster child, or any child declared a dependent on your federal tax return for whom you are the legal guardian with permanent custody. Children are eligible to the end of the birth month in which they turn 26.

  • Children With Disabilities: Must be incapable of self-support due to a mental or physical disability. Children with disabilities may continue as dependents beyond age 26, as long as:

    • Required documentation is approved in advance by the Aetna Claims Administrator prior to the dependent’s 26th birthday
    • They are unmarried
    • They live with you 100% of the time
    • They are declared a dependent on your federal tax return

      For further details and additional assistance, contact Aetna Member Services at 1.800.987.9072 and the UVA Health Plan Ombudsman.

Qualified Life Events: You can make changes to benefit elections during the plan year if you have a qualified life event. Qualified life events and new hire enrollments will need to be completed within 30 days of the event or hire date.

Required documents for qualified life events

Requirements for eligibility for Basic Health

  • You are not a wage employee
  • You do not hold a J-1 visa
  • You are not enrolled in Medicare or Medicaid, or are listed as a dependent on someone else’s tax return
  • You, or your spouse, do not have a balance in a healthcare FSA, are part of a FSA grace period, or your plan year is not over
  • You have not received healthcare benefits from the Veterans Administration (TRICARE) within the last 3 months
  • You do not have a spouse or parent enrolled in a healthcare plan (including a Health Reimbursement Account) that provides you benefits before meeting the annual IRS minimum deductible
  • You have not already contributed the annual federal limit to another HSA, Medical Savings Account (MSA), or HRA in the same calendar year

The difference between a dependent and a beneficiary

dependent is a person who is eligible to be covered by you under the health, dental and vision plans. A beneficiary can be a person or a legal entity that is designated by you to receive a benefit, such as life insurance.

A spouse included in your medical coverage and designated as a recipient of your life insurance is both a dependent and a beneficiary.

For another example, a parent is not an eligible dependent for medical coverage but could be designated as a beneficiary.

 

Required Documentation for Eligible Dependents

Review the Dependent's relationship to you below or click here for the eligibility and required documentation list. 

  • Spouse

    Eligibility Definition

    The marriage must be recognized as legal in the Commonwealth of Virginia.

    NOTE: Ex-spouses will not be eligible, even with a court order.

    Documentation Required

    • Copy of state-issued marriage certificate received after the date of the ceremony with recorded file date, and 
    • Copy of the first and second pages of the employee’s most recent federal tax return that shows the dependent listed as “Spouse”. Page 2 must include signatures or an e-file confirmation number. “Mark out” all financial information and the first five digits of all Social Security numbers.
       
  • Biological Child

    Eligibility Definition

    A child may be covered to the end of the month in which he or she turns age 26.

    Required Documentation

    Copy of birth certificate showing employee as parent

  • Adopted Child

    Eligibility Definition

    A child may be covered to the end of the month in which he or she turns age 26.

    Required Documentation

    Copy of birth certificate or court approved adoption order showing employee’s name. If this is a legal pre-adoptive agreement, it must be reviewed and approved by the UVA HR.

  • Stepchild (spouse's biological child)

    Eligibility Definition

    A stepchild may be covered to the end of the month in which he or she turns age 26.

    Required Documentation

    • Copy of birth certificate (or adoption agreement) showing the employee’s spouse as parent, and
    • Copy of state-issued marriage certificate received after the date of the ceremony with recorded file date showing the employee and dependent parent’s name, and one form of proof of joint ownership, and 
    • Copy of the first and second pages of the employee’s most recent federal tax return that shows the dependent’s parent listed as “Spouse”. Page 2 must include signatures or an e-file confirmation number. “Mark out” all financial information and the first five digits of all Social Security numbers.
  • Foster Child

    Eligibility Definition

    A foster child may be covered to the end of the month in which he or she turns age 26.

    Required Documentation

    • Copy of birth certificate and
    • Copy of Final Court Order granting permanent custody with name of employee as responsible party, name of minor children, and presiding judge’s signature, support order number, and seal
  • Child under your permanent legal guardianship or custody

    Eligibility Definition

    Children for whom a court has ordered the employee (and/or the employee’s legal spouse) to assume permanent custody may be covered to the end of the birth month in which they turn 26, if:

    • they are unmarried
    • reside full-time with employee in parent-child relationship
    • are declared dependents on employee’s federal income tax return, and
    • custody was awarded prior to the childrens' 18th birthday

    Required Documentation

    • Copy of birth certificate, and
    • Copy of the Final Court Order granting permanent custody with name of employee or spouse as responsible party, name of minor children, and presiding judge’s signature, support order number, and seal
  • Child under your permanent legal guardianship or custody – exception

    Eligibility Definition

    If the employee (or the employee’s spouse) shares permanent custody of an “other child” with their minor child who is the parent of the “other child – exception”, then that “other child” may also be covered if the other child, the minor child (who is the parent) and the employee’s spouse (if applicable):

    • All live in the same household as the employee, 
    • Both children are unmarried,
    • Both children are declared as dependents on the employee’s federal tax return, and
    • A court has ordered the employee or the employee’s spouse to assume joint permanent custody.

    Required Documentation

    • Copy of the other child’s birth certificate showing the name of the minor child as the parent of the other child, and
    • Copy of the birth certificate (or adoptive agreement) for the minor child showing the name of the employee, and
    • Copy of the Final Court Order granting custody with names of employee or spouse and their minor child as the responsible parties, name of “other child”, and presiding judge’s signature, support order number, and seal
  • Incapacitated Adult Child

    Eligibility Definition

    The employee’s adult children who are incapacitated due to a physical or mental health condition may be covered beyond the end of the month in which they turn age 26 if:

    • They are permanently and total disabled,
    • They are unmarried,
    • Reside full-time with the employee (or the other natural/adoptive parent),
    • Is declared as a dependent on the employee’s federal income tax return,
    • They are deemed incapacitated prior to the end of the month in which they reach age 26, and
    • They have maintained continuous coverage under an employer-sponsored plan of the employee (or the other natural/adoptive parent).

    Required Documentation

    • Copy of birth certificate or legal adoptive agreement showing employee’s name, and
    • Other medical certification and eligibility documentation as needed
    • In the case of a new employee, copy of the HIPAA Certificate showing prior employer-sponsored coverage

Enroll in Workday

  • To review and elect your benefits in Workday

    • Navigate to Workday
    • In your Workday Inbox, click on the message titled "Open Enrollment Change: [Your Name] on 01/01/2021"
    • Follow the instructions to navigate through each part of the Workday Open Enrollment screens:
      1. Modify medical, dental, vision benefits, if desired
      2. Add or drop dependents, if applicable (adding a spouse requires spousal affidavit to be completed before finalizing your benefits elections). Confirm social security numbers for dependents.
      3. Elect/waive Health Savings Account and Flexible Spending Account
      4. View insurances and long-term disability
      5. Confirm or change beneficiaries for life insurance
      6. If you are not ready to submit, back up one page using your "back" arrow in your browser, and select "Save for Later"
      7. When you are ready to submit, electronically sign at the bottom of the last page and press the SUBMIT button
      8. Workday does not currently offer the option to confirm your elections in writing, so after you submit your elections, it is a good idea to print a copy of your elections confirmation for your records. This will save a PDF of the document, which you can print or save.
      9. Watch for additional emails in your Workday Inbox related to post-Open Enrollment action items you made need to take

     

  • If you Change Your Mind on an Open Enrollment Choice You Made and Open Enrollment Has Not Closed

    You can make changes to your elections as long as the Open Enrollment period is open, even after you have submitted your elections.

    1. From the Benefits app in Workday, click on "Change Open Enrollment"
    2. You will be making changes to what has been previously submitted. Any changes made will need to be resubmitted. If you do not resubmit, the changes will be deleted and the previous submission will remain in effect.
    3. Move through the same screens to elect or waive coverage
    4. Once changes are complete, electronically sign at the bottom of the last page and press the SUBMIT button
    5. Print the new confirmation of benefits elections
  • Open Enrollment Workday System Walk-Through

    Coming soon! Watch a short video that gives step-by-step instructions for navigating the Open Enrollment screens in Workday.

I found the entire experience to be easy to maneuver through; I wasn't looking to change anything, but it was still easy nonetheless. Scott Guynes, Capital Construction & Renovations, Facilities Management

Having trouble finding what you’re looking for?

We strive to make the information on every webpage clear and easy to find. Please let the HR Communications team know if you're having trouble finding what you're looking for, so we can improve your experience on this page in the future. 

For non-website questions or concerns about benefits and Open Enrollment, please contact the HR Solution Center by phone at 434.243.3344, or by email at AskHR@virginia.edu.

For previous Open Enrollment email communications, visit the Open Enrollment Communications Archive webpage.