Learn Who is Eligible for Benefits

Eligibility


Open Enrollment is now closed. If you have questions about your benefits or would like to make changes to your benefits due to a qualified life event, please contact the HR Solution Center at AskHR@virginia.edu.


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

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

  • Spouses:

    • For the UVA Health Plan

      • Must be legally recognized as spouse 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 employer; OR

      • Spouses whose remote employer offers affordable health care that provides minimum value, but ALL of their health options are HMOs and the spouse lives outside the HMOs' defined service areas, are eligible to be a dependent on the UVA employee's health coverage. 

    • 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

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 60 days of the event or hire date.

Requirements for eligibility for Basic Health

  • You are not a wage employee
  • You do not hold a J 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 full 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 Open Enrollment and Dependent Eligiblity

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 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

    A child 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
    • They reside full-time with employee in parent-child relationship
    • They are declared dependents on employee’s federal income tax return, and
    • Custody was awarded prior to the child's 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 totally disabled
    • Are unmarried
    • Reside full-time with the employee (or the other natural/adoptive parent)
    • Are declared as a dependent on the employee’s federal income tax return
    • Are deemed incapacitated prior to the end of the month in which they reach age 26
    • 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

    WDA offers step-by-step assistance directly in Workday. You can also review the Open Enrollment Workday Job Aid on the Workday Central webpage (behind NetBadge), "Happening Now" section.

    A summary of how to review and elect your benefits in Workday is below:

    • Navigate to Workday.
    • In your Workday Inbox, click on the message titled "Open Enrollment Change: [Your Name] on 01/01/2024"; click on "Let's Get Started."
    • Open Enrollment in Workday is organized into "tiles" for each benefit; you will see two sections, one for Health Care and Accounts, and one for Insurance. Each section has multiple tiles. You will start with Health Care and Accounts.
    • You will have three edit options at the bottom of every tile:
      • Manage to make changes to a benefit you already have
      • Enroll to add a new benefit
      • View to see a benefit that is not editable in Workday (more on this further down)
    • Select a tile and choose the edit option for that tile.
    • Once you've selected or waived a benefit in the Health Care and Accounts section, click on Confirm and Continue -- this will take you to a separate window to select or waive eligible dependents for that benefit. Dependents previously enrolled who are eligible will show up automatically, you just need to select or waive each one of them.
    • Click Save to update the benefit tile. This does NOT submit your elections, it just saves the individual benefit tile details you've selected. 
    • Repeat the above process for all six Health Care and Accounts tiles.
    • Workday now offers you a status update on which benefits you’ve touched: "Reviewed," "Updated" or blank if you haven't touched a benefits tile yet.

    Workday benefits tile screenshot

    • Once you've completed the Health Care and Accounts section, move on to the Insurance section. You will see multiple tiles under Insurance.
    • Select a tile and choose the edit option for that tile.
    • Please note that some life insurance benefits are VIEWABLE in Workday but not changeable. Each of these tiles will direct you to where you need to go to make changes. Some of these changes may be outside of Workday.​
    • Once all your benefits have been reviewed and edited as needed, attach any required documents such as birth certificate for new dependents, then click on Review and Sign -- here you can read the summary of what's you elected.
      • New Basic Health participants: Sign and submit the HSA Terms and Conditions authorization form on the Review and Sign page. This document authorizes Fidelity to open your HSA and is required to receive the 2024 employer contribution.
      • New Dependents: If you added new dependents during Open Enrollment (spouse or children), upload required documentation into Workday. You will see a Spousal Affidavit on the Review and Sign page.
    • Click on the I Accept box, then click on Submit to complete your Open Enrollment process.
    • Print this page or save it as a PDF.
  • 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.

    • From the Benefits app in Workday, click on Change Open Enrollment
    • 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.
    • Move through the same tiles to elect or waive coverage.
    • Once changes are complete, electronically sign at the bottom of the last page and press the Submit button.
    • Print the new confirmation of benefits elections or save as a PDF.
  • Look for Additional Tasks After you Submit Your Elections

    Look for additional tasks in Workday related to your Open Enrollment elections:

    • Dependents and Beneficiaries: If you changed your dependents or beneficiaries in Workday, look for possible additional action items in your Workday Inbox.
Thank you for all your hard work to ensure that this year's Open Enrollment was a positive experience for all! HOLLY MIDDAUGH, STUDENT AFFAIRS AND MBA PROGRAM COORDINATOR, OFFICE OF STUDENT AFFAIRS

Having trouble finding what you’re looking for?

We strive to make the information on every webpage clear and easy to find. For benefits questions or concerns, or questions about Open Enrollment, please contact the HR Solution Center by phone at 434.243.3344, or by email at AskHR@virginia.edu.

Please let the HR Communications team know if you're having trouble finding what you're looking for on these webpages, so we can improve your experience on this page in the future. 

For previous Open Enrollment email communications, see the right sidebar box on this page labeled "Open Enrollment Emails."