3-Exhibit 3 - MCCCD Enrollment EOI Rules Modified 010126.xlsx

XLSX spreadsheet 26 KB Posted

Attached to
Benefit Administration with COBRA & FSA/HSA
Solicitation number
RFP 3585-7
Issued by
Maricopa County, Arizona

About this file

This is a Medical Evidence of Insurability (MEOI) Rules exhibit document for the Maricopa County Community College District (MCCCD) in Arizona, outlining benefit administration requirements for a Third-Party Administrator (TPA) or Third-Party Processor (TPE) effective January 1, 2026. The document establishes guaranteed issue coverage amounts and underwriting requirements for optional life insurance and short-term disability (STD) benefits across different employee categories, including Chancellors, Vice Chancellors, College Presidents, General Counsels, and all other active full-time employees. The rules distinguish between new hires, current participants, non-participants, and qualifying events, with specific thresholds that trigger the requirement for Statements of Health (SOH). For life insurance, the guaranteed issue amount is $200,000 for new hires and most current participants, while modified open enrollment rules implemented January 1, 2026 allow current participants to increase coverage up to $50,000 without SOH requirements. For short-term disability, new hires and non-participants require SOH for any election amount exceeding $334.62 per week or $1,450 per month, while current participants require SOH for amounts exceeding these thresholds or when electing more than one increment increase of $34.62 per week or $150 per month.

The document specifies that dependent spouses or domestic partners generally require SOH for any amount of optional life insurance coverage, with limited exceptions for new hires and qualifying event participants. The exhibit identifies MetLife as the external party responsible for testing and verification, with internal verification conducted by Laura Nelson (CSC) and Debra Smith (AE). The rules require administrators to pass only MetLife-approved amounts subject to SOH, and the document includes provisions for providing screenshots of the enrollment process across new hire, late entrant, qualifying event, and annual or evergreen enrollment scenarios. These standardized MEOI rules establish clear guidelines for benefits eligibility and underwriting processes to ensure consistent administration across the MCCCD's benefit programs.

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Text version

Life MEOI Rules Eff 1-1-26

EXHIBIT 3
3585-7 Benefit Administration with COBRA & FSA/HAS
FOR TPA/TPE OR CUSTOMER USEStandard rules after Modified OE
Medical Evidence of Insurability Rules

Outline of Guarantee Issue Coverage

New HireActive FT Chancellors, Vice Chancellors, College President, General Counsel ChancellorsAll Other Active Full Time Employees
Optional Life EEAny amount over the Guaranteed Issue amount of $200,000 elected would require SOH.Any amount over the Guaranteed Issue amount of $200,000 elected would require SOH.
Dependent Spouse/DPN/AN/A
Current ParticipantActive FT Chancellors, Vice Chancellors, College President, General Counsel Chancellors (Guaranteed Issue amount is combined with basic and voluntary life.)All Other Active Full Time Employees
Optional Life EEIf you request to increase coverage by more than 1 increment ($10,000) or if the amount requested is over $200,000 would require a SOH.If you request to increase coverage by more than 1 increment ($10,000) or if the amount requested is over $200,000 would require a SOH.
Dependent Spouse/DPAny Amount would require SOH.Any Amount would require SOH.
Non-ParticipatingActive FT Chancellors, Vice Chancellors, College President, General Counsel Chancellors (Guaranteed Issue amount is combined with basic and voluntary life.)All Other Active Full Time Employees
Optional Life EEAny amount would require SOH.Any amount would require SOH.
Dependent Spouse/DPAny Amount would require SOH.Any Amount would require SOH.
Qualifying Event - ParticipatingActive FT Chancellors, Vice Chancellors, College President, General Counsel Chancellors (Guaranteed Issue amount is combined with basic and voluntary life.)All Other Active Full Time Employees
Optional Life EEAny amount over $200,000 would require SOH.Any amount over $200,000 would require SOH.
Dependent Spouse/DPN/AN/A
Qualifying Event - Non ParticipatingActive FT Chancellors, Vice Chancellors, College President, General Counsel Chancellors (Guaranteed Issue amount is combined with basic and voluntary life.)All Other Active Full Time Employees
Optional Life EEAny Amount would require SOH.Any Amount would require SOH.
Dependent Spouse/DPN/AN/A

Life MEOI Rules 2026 OE

EXHIBIT 3
3585-7 Benefit Administration with COBRA & FSA/HAS
FOR TPA/TPE OR CUSTOMER USE1/1/26 Modified OE
Medical Evidence of Insurability Rules

Outline of Guarantee Issue Coverage

1/1/26- Modified Enrollment- Current ParticipantActive FT Chancellors, Vice Chancellors, College President, General Counsel Chancellors (Guaranteed Issue amount is combined with basic and voluntary life.)All Other Active Full Time Employees
Optional Life EECan increase their coverage, (in increments of

$10,000), up to $50,000 not-to-exceed the new Guarantee Issue amount of $200,000. Can increase their coverage, (in increments of $10,000), up to $50,000 and not-to-exceed the new Guarantee Issue amount of $200,000.

Dependent Spouse/DP Any Amount would require SOH. Any Amount would require SOH.

1/1/26 Modified OE - Non-ParticipantActive FT Chancellors, Vice Chancellors, College President, General Counsel Chancellors (Guaranteed Issue amount is combined with basic and voluntary life.)All Other Active Full Time Employees
Optional Life EEAny amount over the amount of $50,000 elected would require SOH.Any amount over the amount of $50,000 elected would require SOH.
Dependent Spouse/DPAny Amount would require SOH.Any Amount would require SOH.
Definitions:
Modified Enrollment - Current Participant - Increasing coverage as a current participant during a special enrollment period with relaxed underwriting rules

Life Screenshots Provide screenshots for new hire, late entrant, qualifying event and annual enrollment or evergreen enrollment

Disability MEOI Rules

FOR TPA/TPE OR CUSTOMER USE1/1/22 Modified OE
External Party Responsible for Testing:
External Party Responsible for Verification of MEOI Rules:
Internal MetLife Team Member that verified MEOI Rules:Laura Nelson (CSC) & Debra Smith (AE)
Medical Evidence of Insurability Rules
When SOH is requiredTesting Pass/Fail/Incomplete

Administrator should only pass MetLife amount subject to SOH

1/1/22 - Modified OE
New HireChancellorAll other Full Time EmployeesExampleChancellorAll other Full Time Employees
STDN/AAny election amount greater than $334.62 per week, or $1450 per month requires SOH.pass
1/1/22 - Modified OE
Current ParticipantChancellorAll other Full Time EmployeesExampleClass 1Class 2
STDn/aAny election amount greater than $334.62 per week, or $1450 per month or if electing more than one increment increase of $34.62 per week or $150 per month requires SOH.pass
1/1/22 - Modified OE
Non-ParticipantChancellorAll other Full Time EmployeesExampleClass 1Class 2
STDn/aAny election amount greater than $334.62 per week, or $1450 per month requires SOH.pass
Definitions:
New Hire - Enrolling for core or buyup coverage for the first time as a new employee within enrollment window
Modified Enrollment - Current Participant - moving from core to buyup coverage as a current participant during a special enrollment period with relaxed underwriting rules (usually 1st enrollment after installation of customer)
Modified Enrollment - Non- Participant - Enrolling for core or buyup coverage for the first time as a current employee (late entrant) during a special enrollment period with relaxed underwriting rules (usually 1st enrollment after installation of customer)

Disability Screenshots Provide screenshots for new hire, late entrant, qualifying event and annual enrollment or evergreen enrollment image1.png

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