The THT Eligibility Department oversees your enrollment, including your plan selections and dependents.
Enrollment
Eligibility
You are eligible for benefits on the first day of the month following your date of hire if you are any of the following:
- A Clark County School District (CCSD) licensed employee paid on the licensed employee salary schedule and eligible for representation by the Clark County Education Association (CCEA). Note: July new hires are not eligible for health benefits until September 1.
- A licensed employee teaching at a participating charter school (Rainbow Dreams Academy, Odyssey Charter Schools, or Delta Academy).
- An employee of the Clark County Education Association (CCEA).
- An employee of the Teachers Health Trust.
- An active Trustee of the Teachers Health Trust Board of Trustees in the role of a community representative.
Many of the plans allow you to cover your eligible dependents, which include:
- Your legal spouse or registered domestic partner.
- Your children to age 26, regardless of student, marital, or tax-dependent status (including a stepchild, legally adopted child, a child placed with you for adoption, a child for whom you are the legal guardian or dependent children of a domestic partner that meet eligibility requirements).
- Your dependent children of any age who are physically or mentally unable to care for themselves.
Submit a Change / Qualifying Life Event
Due to IRS regulations, once you have made your elections for the current plan year, you cannot change your benefits until the next annual open enrollment period. Open enrollment is once a year during summer/fall. Changes made during Open Enrollment become effective at the start of the next plan year, which is typically October 1.
Outside this period, changes can only be made if you experience a Qualifying Life Event (QLE). A qualifying life event is a specific event that allows you to add or remove a dependent to your plan without having to wait for open enrollment. Election changes must be completed through the THT member portal within 31 days of the life event, including uploading any required supporting documentation.
As long as the life event is submitted within the eligibility window, the effective date of benefits for your dependent will be the first of the month following the life event date. (Except in the case of birth and death events, where the effective date will be the date of birth or date of death, respectively.)
Life Event Submission Deadline
Per IRS regulations, life events and supporting documentation must be submitted within 31 days (except in the case of a birth, which has a 60-day submission window). Requests submitted within 32-60 days following a life event will incur an administration fee of $100.
Did you Qualifying Life Event occur more than 60 days ago?
- Requests to add dependents submitted after 60 days cannot be accepted unless appealed and approved.
- Requests to remove dependents submitted after 60 days can be accepted if submitted prior to the following September 30th and with proper documentation. Upon review and approval, coverage for your dependent(s) will terminate at the end of the month in which the submission is received. There will be no premium refunds for approved life events outside the 60 day window.
If you experienced extenuating circumstances that prevented you from meeting the deadline, you may provide additional explanation and documentation for consideration via an Eligibility Appeal.
Arrears and Refunds Due to an Approved Life Event
Since most life events are processed retroactively, there may be a refund or additional premium due. These are processed within 1-2 pay cycles and an email notification with the affected paycheck and amount is sent to the email address on file.
Qualifying Life Events to Enroll or Add Dependent(s)
If you have recently experienced one of the following life events, you may qualify to add your dependent to your plan:
- Birth or adoption of a child: (requires certified birth certificate or adoption placement / adoption decree)
- New Marriage or New Domestic Partnership: (requires Certified Marriage Certificate or Registered Domestic Partnership Certificate)
- Loss of Coverage: if you or one of your eligible dependents had coverage with another employer / carrier, but lost that coverage, you can enroll in a THT plan (requires a Certificate of Coverage: a document that comes from the insurance carrier and includes each individual’s name with date of when active coverage began and terminated. It cannot come from the employer. Your ID card does not suffice as a certificate of coverage.)
Qualifying Life Events to Waive or Remove Dependent(s)
If you have recently experienced one of the following life events, you may qualify to remove your dependent off your plan:
- Gain of Coverage: if you or your dependent(s) gained coverage from another employer or carrier, you have a qualifying life event (requires a Certificate of Coverage: a document that comes from the insurance carrier and includes each individual’s name with the date of when active coverage began. It cannot come from the employer. Your ID card does not suffice as a certificate of coverage.)
- Death of a dependent: (requires Death Certificate)
- Divorce or termination of Domestic Partnership: (requires Divorce Decree or Domestic Partnership Termination)
Gained Outside Insurance?
Before you waive, check out our supplement plans which enhance your existing medical coverage at no addition cost.
Dual District Benefit
THT offers reduced premiums when two active, benefits-eligible, licensed employees from CCSD, participating Charter schools, CCEA, or THT combine health plans.
One employee must be designated as the primary policyholder; the other becomes a dependent. Note: CCSD school administrators, support staff, and police cannot serve as the primary policyholder in a Dual District Policy.
If you and your partner wish to combine plans under THT, fill out the form below and submit it via the THT member portal. If you wish to combine plans under another group (e.g. CCSD support, admin, or police), you will need to submit a qualifying life event in the THT member portal to waive your THT coverage.
Dual District members are not eligible for either of the supplement plans.
Dual District Premium Calculator
Effective 10/1/2024, premiums for Shared Contract employees and Dual District families with a Support or Police employee will change. For more details, visit the 2024 Open Enrollment page.
Out of Area
The network you have access to is determined by the zip code we have on file.
- If you have a zip code listed in Clark County or Nye County, the network with the best benefit available to you is the Sierra Healthcare Options (SHO) network.
- If you or your dependent resides outside of Clark County, you will have access to the United Healthcare Choice Plus network. You must notify THT to request this change in your network status. Fill out this form within 10 business days of your address change.
These are the instances when you can access the United Healthcare Choice Plus network even if you reside in Clark County or Nye County:
- The service or procedure is medically necessary (referred by a physician)
- The service is emergent or urgent
Required Documents
Teachers Health Trust (THT) requires supporting documentation to establish a dependent’s eligibility for coverage. THT has the right to request documentation as often as deemed necessary. Failure to provide requested documentation or respond to the Eligibility & Enrollment department within 31 days of enrolling may result in penalty fees or delayed/denied enrollment.
Social Security numbers must be provided at the time of enrollment for all family members the employee would like enrolled in THT coverage. Please ensure that all documents from other languages are kindly translated into English.
Required documents by dependent type
- Spouse: Copy of certified marriage certificate or most recent tax return with a signed affidavit.
- Registered Domestic Partner: Copy of a certificate of state registered domestic partnership.
- Children/Stepchildren up to age 26: Copy of certified birth certificate which includes one or both of the parents’ names, issued by either the state or country of birth. Hospital-issued birth certificates are not accepted. If the dependent is the child of your spouse or domestic partner, you must submit your marriage certificate or registered domestic partnership certificate, respectively.
- Adopted Children up to age 26: Copy of legal adoption papers or placement for adoption (signed by a judge), followed by final adoption papers within 60 days of issuance.
- Children over 26 with a disability: Certification of Disabled Dependent Child Form (completed by primary participant and child’s physician). Verification that the child has had continuous health insurance since the age of 26 years and proof of support and maintenance through the submission of a copy of the Participant’s preceding year’s income tax returns showing the child is a tax Dependent. The Plan will thereafter require proof of the child’s continuing incapacity and dependency not more than once a year beginning 2 years after the child attains age 26 (NRS 689B.035).
Teachers Health Trust makes a special exception for members who wish to remove a dependent in the middle of the plan year, but don’t have a qualifying life event. Submit a Life Event in the member portal under the “My Dependents” tab. Be sure to use the life event type “Dependent Removal” or the request will be denied. Upon review, our team will remove your dependent at the end of the month in which the submission is received.
