When Can I Enroll?

Since your premiums for medical, dental and vision insurance and reimbursement accounts are pre-tax, federal law limits when you can change your elections for these benefits.

Changes made outside of the annual Open Enrollment period are allowed only within 30 days of a “qualifying event” such as marriage or divorce, birth or death of a dependent, or a change in insurance eligibility due to relocation of residence or work. For more information on qualifying life events, visit Life Events Information.

Who Can I Enroll?

You can enroll the following dependents for medical, dental and vision insurance:

  • Your legal spouse
  • Same-sex spousal equivalent registered with Duke HR prior to January 1, 2016
  • Your children (includes your biological children, stepchildren, adopted children, children of your registered same-sex spousal equivalent, or foster children) or children for whom you are a legal guardian*, up to their 26th birthday. Dependent children do not include grandchildren, siblings or other family members, or children for whom you have legal custody but not guardianship.
  • We may request dependent documentation at any time. This documentation includes birth certificates, marriage certificates, and the first page of your tax return.

Update Your Personal Information

During the Open Enrollment period, staff and faculty should review and update their personal data and information in the Duke@Work self-service website. Updated contact information helps ensure that you receive benefits communications throughout the year.

How Much Coverage Can I Purchase?

When making your medical, dental, and vision benefit elections, you may choose from among the following levels of coverage:

  • Employee
  • Employee/Child
  • Employee/Children – only available for medical and vision insurance**
  • Employee/Spouse
  • Family (includes Spouse)

Your premium for coverage – including your contribution and Duke's contribution – will vary, depending on which level of coverage you select. Premiums for each level of coverage are on page 2.

Social Security Numbers for Dependents

As part of compliance with the Affordable Care Act, Duke must request all employees to confirm or provide Social Security numbers for dependents enrolled in medical coverage.

You can review or add the Social Security numbers for covered dependents through the enrollment process on the Duke@Work self-service website or by calling the Open Enrollment Service Center at (919) 684-5600, option 1.

Same-Sex Spousal Equivalent Information

All faculty and staff, regardless of sexual orientation, must be legally married to cover a partner or partner's child for benefits or applicable policies. Same-sex spousal equivalents who were registered with Duke Human Resources prior to January 1, 2016 are eligible for coverage, but will not be able to take advantage of federal and state tax savings for payment of benefit premiums unless legally married or able to claim one's partner as a dependent as defined by the IRS and tax code.

*Legal guardianship obtained outside of NC must meet the NC qualifications.

**Dental care coverage does not include an Employee/Children option. You may cover any number of eligible children in the dental plan by choosing the Family option.

Key Terms

Coinsurance: is the percentage of costs that you pay for a service after you meet your benefit period deductible

Copay or Copayment: is a fixed dollar amount that you must pay for a medical service

Deductible: the amount you are responsible for paying before your insurance plan begins to pay for covered services.

In-Network Provider: any healthcare provider (physician, hospital, urgent care or other facility) that is contracted by the insurance administrator to provide health care services

Out-of-Network Provider: any healthcare provider that does not belong to your insurance company's preferred provider network. If the Out-of-Network provider charges more for a service than your insurance company agrees to pay, you will need to pay the difference. This payment does not count toward your out-of-pocket limit.

Out-of-Pocket Limit: the maximum dollar amount

that a member or family could pay in a year for covered services before the plan pays 100%. Any deductible, copayment, and coinsurance amounts that you pay count towards the out-of-pocket limit.