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© 2019 by Kurell Hodge

DIVISION OF PERSONNEL

3438 Kronprindsens Gade
3rd Floor GERS Bldg
St. Thomas, Virgin Islands 00802

Division of Personnel

Group Health Insurance Unit

The Group Health Insurance office manages and maintains medical, dental and life insurance benefits for employees and retirees of the government.

 

 

Medical and Dental Coverage

Enrollment

The Virgin Islands government offers to full-time employees and their eligible dependents, a group health and dental insurance plan.

 

Full-time employees must enroll within thirty-one (31) days of hire unless they can provide proof of medical coverage from another source. An employee who does not enroll within 31 days of employment will be automatically enrolled in the health insurance plan with single coverage.

 

If an employee fails to enroll dependents within the initial eligibility period he/she must wait until a period of “open enrollment” is announced or have a qualifying event as determined by the health insurance carrier to enroll dependents or make changes to their coverage.

 

Effective Date of Coverage

If enrollment forms are received on or before the 6th of the month, coverage will be effective on the first day of the first month following the receipt of enrollment forms. If enrollment forms received on the 7th of the month or later, coverage will be effective on the first day of the second month following the receipt of the enrollment forms.

 

 

Dependent Coverage

Dependents of eligible employees may participate in the Group Health and Dental Insurance Program according to the terms and conditions imposed by the Health Insurance Board of Trustees and/or the carrier. Eligible dependents are the employee’s:

  1. Legal spouse;

  2. Natural children;

  3. Adopted children; and

  4. Step children.

 

When a new dependent is acquired, you must enroll them within thirty-one (31) days after acquiring such dependent. When enrolling a dependent at any time, the following may be required:

  1. Birth certificate;

  2. Marriage certificate;

  3. Adoption papers; and/or

  4. Legal papers of appointment.

Various other documents may be required to determine the eligibility of the dependents.

 

Cost of Coverage

The GVI contributes toward the cost of Health Insurance for each employee enrolled under the Group Health Insurance Program. The GVI reserves the right to change the amount of the employee contribution when necessary for financial or other reasons.

 

Dental Insurance

As a condition of participation, all employees must enroll in medical coverage to qualify for Dental Insurance.

 

Waiver or Discontinuation of Benefits

An employee may opt to decline coverage, or discontinue coverage under the Group Health and Dental Insurance Plan at any time. An employee who waives coverage upon employment, or who drops out of the program must provide proof of medical coverage and will be subject to the eligibility requirements imposed by the carrier in order to re-enroll in the program. This provision also applies to dependents that are dropped from the plan.

 

Coverage discontinues on the last day of the month following a qualifying event or on the date of an employee’s separation.

 

After separation, an employee or dependent may be eligible to convert their group policy to an individual policy within 30 days, depending on the insurance carrier. If an employee would like to convert their policy to an individual policy a notice of conversion must be sent to the insurance carrier. Consolidated Omnibus Budget Reconciliation (COBRA) coverage is not available in the Virgin Islands after loss of coverage. 

 

Leave without Pay

The GVI will maintain group health insurance plan coverage for employees on leave without pay. This coverage will remain at the level and under the conditions for which coverage would have been provided if the employee had continued employment continuously for the duration of the leave. However, employees on leave must arrange to pay into the Group Health Insurance Fund the employee’s share of their health insurance premium to maintain coverage.

 

Retirement Benefits

Retired employees and their dependents are eligible to continue to participate in the Group Health and Dental Insurance Program. Retirees must provide updated contact information to the Group Health Insurance Division to maintain coverage.

 

Life Insurance

The government provides a complementary basic non-contributory $10,000 basic life insurance benefit. In order for the benefit to be effective, an enrollment form must be forwarded to the Group Insurance Office at the Division. The enrollment form must be signed, dated and must indicate a designated beneficiary.

 

Employees may also elect additional life insurance in either 1x, 2x, 3x or 4x base salary or $10,000, $15,000, $25,000, $50,000, $75,000, $100,000 or $150,000 amounts as supplemental contributory coverage. The employee pays the cost of this additional insurance and may be required to submit evidence of insurability when increasing coverage after initial enrollment. Insurance enrollment forms and booklets explaining in detail the plan of benefits, as well as claim forms and a schedule of costs, may be obtained from the Group Health Insurance Office.

 

Upon retirement, life insurance benefits may be reduced.

 

Upon death the designated beneficiary will be eligible to receive the life insurance proceeds of the insurance participant, the Division must be notified of the death in order to initiate the claim process. Life insurance benefits are payable by the contracted insurance company and a subject to the limitations established by the insurance company.

 

Supplemental Insurance

The GVI has several supplemental insurance plans that provide for coverage over and above the regular medical, dental and life insurance coverage.

 

These plans are voluntary and are not contributed to by the GVI. A list of the current supplemental insurance plans is available through the Group Health Insurance Office. An employee who does not wish to enroll in medical coverage is eligible to enroll in supplemental insurance.

 

Employee Assistance Program (EAP) 

The GVI will provide confidential and voluntary assistance through its Employee Assistance Program (EAP) to all employees and their family members who may be faced with dynamic challenges of financial concerns, legal issues, alcohol or drug problems, marital problems, illness of a family member, emotional worries, child care problems, etc. For the welfare of employees as well as effective business operations, the GVI encourages its employees to take advantage of this valuable benefit of employment with GVI.

 

Application

Employees and their family members can refer themselves to the EAP. The program may be reached 24 hours a day on weekdays and weekends.

 

EAP counselors are available to meet with employees or family members to assess a problem and develop a plan for resolution. The counselors may suggest a referral to an outside resource, such as a therapist, Departmental resource, physician, treatment facility or other professional that would be appropriate to assist in resolving the problem or situation. Where an employee may be in need of information, a referral or suggestion may be made over the telephone. There is no charge for employees or their families to use the services of the EAP.

 

Participation in the EAP Program does not jeopardize job security or promotional opportunities. However, it does not excuse the employee from following GVI policies and procedures or meeting required standards for satisfactory job performance except where specific accommodations are required by law.

 

Time Away from Work

Employees who want to visit the EAP during regular work hours must use sick, vacation or personal time after their first meeting. If illness is involved, compensatory, sick, and/or annual leave may be used for treatment or rehabilitation on the same basis that it is granted for other health problems.

 

Mandatory EAP meetings will be completed using administrative leave.

 

The EAP counselors will make every effort to coordinate referral for ongoing treatment with the employee's health insurance coverage as well as his/her ability to pay.

 

Mandatory EAP

When an employee's job performance or attendance is unsatisfactory or there appears to be signs of other problems during the work day, the supervisor should counsel the employee in consultation with the human resources officer or designee. If the employee appears to be unable or unwilling to correct the situation, the employee may be referred to the EAP to assist in the resolution of the problem. Depending on the situation, the employee may accept or refuse participation in the EAP. However, there may be situations where continued employment with the GVI may be contingent upon the employee calling the EAP for assistance.

 

REMINDER: All contact between an employee and the EAP is held strictly confidential. In cases where an employee's continued employment is contingent upon calling the EAP, the EAP counselor will only verify whether or not the employee has contacted the EAP, if ongoing treatment is necessary, and that the employee is following through on the treatment.

 

Meet The Team

Valerie Daley,

 Chief Group Health Insurance

Marie Vanterpool – Health Insurance Officer

Ahzullah Nibbs – Health Insurance Officer

Denise Parker – Health Insurance Clerk

Sparkle Estrill – Administrative Client Services Assistant