Summer Insurance Premium Q&A

Am I eligible for insurance benefits during the summer months?

Typically, benefit eligibility only continues through the last day of the month in which you actively worked. However, System Regulation 31.02.02 does have a provision for those employees who are appointed to work less than 12 months to allow benefit eligibility during the time they don't work (summer period) provided certain conditions are met. These conditions include:

  • You are a regular, benefits-eligible employee scheduled to work  in an appointment that is less than 12 months who satisfied that appointment, AND
  • You are expected to continue employment in a benefit-eligible position the following fiscal year (Fall term)

If you meet the above two conditions, then you are eligible to participate in the insurance plans and will maintain the employer contribution towards benefit premiums. Your eligibility would change at the point in which the expectation to return in the Fall is no longer applicable.

As an employee who works an appointment that is less than 12 months, how will I pay my summer insurance premiums since I am not receiving a paycheck?

Summer insurance premium notifications are sent around April 15 of each year to employees who are listed in the payroll database with an appointment of less than 12 months. This letter specifically explains how your summer premiums will be handled. This document is imaged in HR Connect and is available under Current Benefits in the "Insurance Documents" section.

Individuals who are employed in an appointment that is less than 12 months, but are expected to return in the Fall will have their portion of entire summer premiums deducted on their May paycheck unless they receive an additional summer appointment that covers the entire summer at the same percent effort.

Will you explain the summer premium deduction for those who are appointed for less than 12 months?

The summer insurance premiums will be deducted in advance from the May paycheck to include your portion of the premiums for May, June, July and August.

  • If you are paid monthly, these deductions will occur on the paycheck you receive on June 1.
  • If you are paid bi-weekly, these deductions will occur evenly on the two paychecks you receive during the month of May on May 12 and May 26.
Who should I contact if I have questions regarding the summer premium notification I received?

If you have specific benefits questions related to your summer premiums, you should contact Benefit Services at (979) 862-1718 or benefits@tamu.edu.

If you have specific questions regarding your employment status or appointment, you should contact your Department HR Liaison directly. If you need assistance determining your HR Liaison, utilize the website to find the appropriate contact person.

How are my summer premiums impacted if I receive an appointment to work during the summer?

Working an additional summer appointment during the summer may potentially impact your summer premiums, but it ultimately depends on several factors to determine that impact. Below are some examples:

Partial appointment for the summer:

employees who are appointed less than 12 months will pay their summer insurance premiums in advance on the May paycheck(s). If you have only a partial summer appointment you are still considered less than12 months. Therefore, your summer premiums will pull in advance on the May paycheck. Then, any subsequent paycheck(s) you receive during the summer will not include insurance deductions.

Additional  summer appointment covering the entire summer at the SAME percent  effort:

if you receive an additional appointment for the entire summer at the SAME percent effort and you will receive a paycheck each month during the summer, then your summer insurance premiums will be deducted evenly over each of those month's paychecks (provided the additional appointment is processed by your department and Payroll Services prior to the May payroll calculation).

Additional summer appointment covering the entire summer, but at DIFFERENT percent effort:

The employer contributions are calculated based off the funding and percent effort that is in affect at the time the deductions occur.

Therefore, if the change in percent effort has a negative impact on the level of the employer contribution towards the insurance premiums and would decrease that amount, your insurance premiums will be determined and calculated on your May employment effort as if you did not have the additional summer appointment. Therefore, the summer premiums will pull from the May paycheck at the higher employer contribution levels. Any subsequent summer paychecks would not include the insurance deductions because they were paid in advance.

If the increase in effort has a positive impact on the employer contribution level or has no impact at all, then your summer insurance premiums will be deducted evenly over each of those paychecks (provided the additional appointment is processed by your department and Payroll Services prior to the May payroll calculation).

Summer appointment as a student worker:

Summer appointments as a student worker are considered a secondary appointment to your benefits-eligible graduate assistant position provided that you are returning to the graduate assistant position in the Fall. Therefore, the summer student worker position does not impact your summer benefits. Your premiums will continue to be handled as other employees working less than a 12 month appointment and are deducted from your May paycheck. Any pay received during the summer in the student worker position will not include insurance deductions.

If your specific circumstance is not addressed here, please contact Benefit Services at (979) 862-1718 or benefits@tamu.edu to discuss further.

Who should I notify if I know there will be a change in my employment status during the summer?

You should notify your Supervisor and HR Liaison when you are aware of changes in your employment status that will occur during the summer period. This includes intention to retire from Texas A&M University or to end your employment.

To maintain summer benefit eligibility, you must have the expectation to return in the Fall. Once your department is notified that you will not be returning in the Fall, they are to complete the Employee Payroll Action (EPA) to end the employment relationship and your benefits will only go through the last day of the month in which that notification occurred.

What happens to my summer benefits if I end my employment?

You are eligible for summer benefits if you are expected to return to your benefit-eligible position in the Fall. When you end your employment or when it becomes evident that you are not expected to return to a benefit-eligible position, then your benefits will cancel at the end of the month in which either situation occurs. Any premiums that you may have paid in advance for any full month of coverage after cancellation will be refunded.

What happens if my May paycheck does not have enough money to cover the summer premiums?

Benefits Services receives a report of individuals whose May paycheck appears to not be large enough to cover the summer premiums.  Impacted individuals are moved to summer billing and will be provided additional information by their Benefits Representative.

If your actual paycheck is not large enough to cover your summer premiums, you will be contacted by your Benefits Representative regarding your summer premiums owed.

What if I cannot afford the summer premiums, can I drop coverage during the summer?

Changes to benefit coverage outside the annual enrollment period require a qualified change of status as defined by IRS guidelines. The ability to pay for premiums is not considered a qualified change of status. Therefore, you would not be permitted to cancel or drop coverage unless you experience an appropriate qualified change that would allow for that type of benefit change.

If you have a qualified change of status, please contact Benefit Services at (979) 862-1718 or benefits@tamu.edu to discuss further.

What should I do if I experience a qualified family change in status change during the summer that requires a dependent to be added or dropped from coverage and how does that impact my premiums?

As with any time of the year, if you experience a qualified change in status, you should complete the necessary benefit forms to request the appropriate change in benefits within the designated benefit change window (60-days of the change in status). If the change in status results in a change to your coverage tier (employee only, employee + children, employee + spouse, employee + family), an adjustment will need to be made to your summer premiums paid in advance. This could be either a refund of extra premiums paid or additional premiums owed depending on the circumstances. Your Benefits Representative will communicate directly to provide specific guidance for your situation.

How are my summer premiums handled if I have participated in the Extended Pay Plan throughout the year?

If you participated in the Extended Pay Plan your summer premiums will be deducted from your May paycheck even if you receive a summer appointment. The premiums for May, June, July and August will be deducted from your May paycheck; however, you will receive an additional payment from your extended pay plan account to reimburse you for the summer premiums during the summer months.