2019 Eligibility

  • Full-time or part-time Mohawk employees scheduled to work 30 hours or more per week are eligible for Mohawk benefits the 1st of the month following 60 days of employment for all plans.
  • The medical, dental and vision coverage plans offer six levels of coverage (also called coverage tiers) - or you may decline coverage.

Coverage Level

Who's Covered

Employee Yourself only
Employee + Spouse

Yourself and your Spouse

Employee + Child(ren)     

Yourself and one or
more children

Employee + Family

Yourself, your spouse and
one or more children

Waive

No coverage

Dependent Eligibility — Health Care Plans (Medical, Dental, Vision)

You may enroll your dependents for coverage under the plan only if you are covered. If dependents become ineligible, you are responsible for notifying the Company within 31 days of loss of eligibility. Recovery of claims paid to ineligible dependents may be requested.  The Company has contracted with Hodges-Mace, LLC to verify dependent eligibility.  Employees who add a dependent as a result of Open Enrollment, New Hire, or Qualifying Life Event during the year will be contacted by Hodges-Mace, LLC within 4-6 weeks after the effective date for proof of dependent eligibility.

It is the employee's responsibility to provide proof of dependent(s) eligibility (which may include Social Security Number).  If no proof is provided, the dependent will lose coverage under the plan.

Spousal Healthcare Coverage Eligibility & Surcharge

An Employee whose Spouse enrolls in the Company Medical plan and has access to other group medical coverage through their employer will be assessed a surcharge of $28.85/wk or $125/mo.  If you have not submitted the Spousal Healthcare Coverage Eligibility Affidavit form or your spouse's healthcare coverage eligibility has changed, please submit the form to Hodges-Mace, LLC.

pdf button Spousal Healthcare Coverage Eligibility Affidavit Form

FAX TOLL FREE TO: 1-888-205-0425  OR
EMAIL TO: This email address is being protected from spambots. You need JavaScript enabled to view it.

For purposes of the plan, dependent means your -
  • Spouse
    • The term "spouse" includes common law spouses of the opposite sex
    • Common Law Spouse: If you reside in one of these states only (AL, CO, DC, IA, KS, MT, RI, SC, TX or UT). Refer to the Dependent Eligibility Matrix for details.
  • Child or Stepchild
    • Under 26 years of age*
    • Over 26, primarily supported by you and incapable of self-sustaining employment by reason of mental or physical disability
    • For whom benefits must be provided under a Qualified Medical Child Support Order**

For additional Dependent Eligibility requirements, please refer to the Dependent Eligibility Matrix.

Documents / Forms

Dependent Eligibility

Spousal Healthcare Coverage

pdf button Spousal Healthcare Coverage Eligibility Affidavit Form


Contact the Benefits Service Center or Hodges-Mace

Benefits Service Center 1-866-481-4922  OR

Hodges-Mace (877) 308- 9157 toll-free 8 A.M. to 8 P.M. EST Monday through Friday | Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

* Dependent child coverage is through the end of the month of his/her 26th birthday.  It is the employee's responsibility to remove a dependent no longer eligible .
** Please contact the Benefits Service Center at 1-866-481-4922 for assistance with adding a child(ren) to your benefits in accordance with a Qualified Medical Child Support Order.

 

 

Save

Save

Save

Save

Save

Save

Save

Save

Save

Cigna
1-855-566-4295
WebTPA
1-844-380-4564
Express Scripts
1-877-887-2879
Cigna MDlive
1-855-818-3627
Metlife
1-855-488-0520
Aflac
1-800-433-3036
TaxSaver Plan
1-888-602-6272
Fidelity
1-800-835-5087
One America
1-855-279-6375
HLC
1-877-365-0051