Before you receive health benefits from the Equity-League Funds (ELF), you must: a) qualify for coverage and, b) pay the required premium for that coverage. This page describes our eligibility requirements and the steps you take to enroll.
How do I qualify for coverage?
• If you work in covered employment for at least 11 weeks (but fewer than 19) in an accumulation period, you qualify for six months of coverage.
• If you work for 19 or more weeks in an accumulation period, you qualify for a full 12 months of coverage.
After you meet these qualification requirements, there is a two-month waiting period (after the end of your accumulation period). After the waiting period, your medical and vision coverage will begin. For instance, if you worked 11 weeks between January and December of a given year, your coverage would begin on March 1 of the following year.
How do I enroll for health coverage?
Where can I check my work history?
From within the portal, you can check your progress toward eligibility. The portal displays your work history on a color-coded calendar. This makes it easy to see work weeks that may be credited toward eligibility for coverage, versus weeks for which we have no record of any work or weeks which have already been used for eligibility.
ELF staff also checks this for you monthly, and we will notify you when you first qualify or newly qualify for coverage.
What are my coverage choices?
Everyone who qualifies for coverage may choose to enroll in the Cigna Open Access Plus (OAP) Plan. The Cigna Plan offers a nationwide network of providers and allows you to see almost any doctor without a referral. In addition, if you live in certain areas of the country, you may choose one of the regional HMO Plans we offer in those areas. The HMO Plans provide coverage for many preventive services and other types of care at little or no cost out-of-pocket. However, you must choose a primary care physician (PCP) to coordinate your care and authorize any referrals to Specialists. Generally, you may not use health care providers who are not in the HMO’s network.
Here is a list of the currently available HMOs:
• Southern California (Kaiser Permanente)
• Northern California (Kaiser Permanente)
• New York (HIP, an Emblem Health Company)
• Washington, DC (Kaiser Permanente)