FAQ

Any employer may participate if all the following criteria are met:

• at least one working physician is an SCMA member;
• the entity has at least two employees;
• the group maintains at least 50% participation (valid waivers count as participating);
• the employer completes a Participating Employer Agreement and any required documents;
• MIT accepts the employer for participation; and
• the employer contributes at least 50% of the cost of employee‑only coverage.

Full‑time employees (30+ hours/week), their spouses, and dependents are eligible for coverage.

Yes. MIT recognizes legally recognized common‑law marriages entered into on or before July 24, 2019, based on a South Carolina court ruling. A notarized affidavit must be remitted to MIT affirming the legally recognized common law spouse.

Your Participating Employer determines which Plan options are available to employees. You may enroll:

• As a new hire, anytime after your first day of employment once you satisfy your employer’s waiting period, or
• During your employer’s annual open enrollment period, which typically occurs in November/December for a January 1 effective date.

Yes, if you experience a qualifying life event or meet the Plan’s special enrollment rules. See your MIT Summary Plan Description (SPD) for details.

MIT must be notified in writing (MITinfo@scmedical.org) within 90 days of birth or adoption of a dependent child. Failure to enroll the dependent child within the 90-day deadline will result in coverage not being extended to your child. If you are not already enrolled, you must enroll yourself and the child within the same timeframe. All other qualifying life events must be reported to MIT within 31 days of the date the event occurs.

Yes—through age 26 (with extended coverage available for handicapped dependents). Eligible dependents include:

• Biological children
• Adopted children/children placed for adoption
• Stepchildren
• Children for whom you have legal custody and who live with you in a parent‑child relationship

Yes. You must notify MIT (MITinfo@scmedical.org) and submit a completed “Disabled Dependent Child Certification” signed by a medical provider within 31 days after the child turns 26 to maintain eligibility.

Yes. If the employee was covered for the three previous years and the spouse applies within 31 days of the employee’s death, coverage may continue. See MIT’s SPD for coverage duration and other related specifics.

Coverage begins on the 1st of the month after your employer’s selected waiting period.

Participating Employers may choose a waiting period ending on the 1st of the month after hire or a 30‑ or 60‑day waiting period. In all events, the maximum waiting period can be no later than the 91^st day, as required by the Affordable Care Act. MIT must receive your properly completed enrollment forms within 31 days after the date you become eligible and complete your employer’s established waiting period.

MIT must receive properly completed enrollment application forms within 31 days of the date you become eligible per your employer’s established waiting period. If this deadline is not met, you may have to wait to enroll during the next annual enrollment period for your Participating Employer.

No. The same waiting period applies to all of the Participating Employer’s employees. MIT may approve exceptions only in specific scenarios (e.g., upon an employer first joining MIT or the acquisition of another business).

Yes—during your Participating Employer’s annual enrollment period or if they experience a qualifying life event (special enrollment).

It depends:

• Privately purchased plans (not through a state exchange): rate increases do not qualify for mid‑year “special enrollment.”
• Marketplace or employer plans: dropping coverage during that plan’s open enrollment does permit mid‑year MIT enrollment.

Mission: Deliver cost‑effective, comprehensive health insurance solutions tailored to physician practices in South Carolina.
Values: Coverage Physicians Trust. Services Practices Rely On.

No. MIT is a self‑funded MEWA (Multiple Employer Welfare Arrangement) sponsored by the South Carolina Medical Association (SCMA). MIT has provided group health coverage for over 40 years.

MIT is overseen by a five‑member physician Board of Trustees, who act as the Plan Administrator and fiduciaries under ERISA. SCMA serves as the Plan Sponsor.

No. MIT files a single return for all Participating Employers.

Although it functions similarly to a fully insured plan, MIT offers advantages of self‑funding, including:

• Lower premiums through pooled experience
• Ability to influence costs through wellness initiatives
• No financial exposure in high‑claims years
• Reduced administrative burden

Yes. As an MIT Member, you can create accounts for viewing both medical claims and pharmacy claims.

• Medical claims: via My Health Toolkit (My Health Toolkit​ | Blue Solutions Administrator)
• Pharmacy claims: via Express Scripts (Login | Express Scripts Members)

Yes. Refer to the “Precertification and Prior Authorization” section of the MIT Summary Plan Document (SPD).

Call Blue Solutions Administrator Precertification/Prior Authorization at 888‑376‑6544 before major elective procedures. Failure to obtain authorization may reduce the amount the Plan pays or the claim may be denied.

Coverage always ends on the last day of the month in which employment ends or eligibility changes.

Participating Employers receive Employer Contribution credits only for periods beginning after MIT receives termination notice.

Submit written notice to MIT at:
MITinfo@scmedical.org
or
132 Westpark Blvd, Columbia, SC 29210

Termination becomes effective on the last day of the month when MIT receives the notice (or a later requested month).

Yes—within 31 days of:

• Death of a covered employee
• Employment termination or reduction in hours
• Employee becoming entitled to Medicare

Failure to notify MIT may result in liability or loss of COBRA rights.

Yes—within 31 days of:

• Divorce or legal separation
• Dependent losing eligibility
• Family status change or special enrollment event
• Handicapped child reaching age 26

The Participating Employer must notify MIT within 31 days of any change in an employee’s eligibility.

No. Employees may keep MIT coverage, with MIT as primary and Medicare secondary, as long as they are actively employed. Dropping MIT due to Medicare enrollment is not a COBRA event and dependents do not receive COBRA rights in that scenario.

• The individual’s COBRA coverage ends.
• Covered dependents may continue COBRA independently.

• COBRA elected after Medicare enrollment: COBRA continues normally
• COBRA elected before Medicare enrollment: COBRA ends upon Medicare entitlement
• Spouse/dependents: May receive up to 36 months of COBRA if the employee’s qualifying event occurs within 18 months of Medicare entitlement.