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Benefit Changes during the Year

You have the ability to change your medical, dental, vision, and flexible spending account elections and coverage levels each year during Open Enrollment. The elections you make are generally in effect for a full plan year (January 1--December 31). IRS regulations allow you to make changes to your benefit elections during the year only if you have a qualified change in employment or family status.

Examples of qualified changes in status include:

  • Marriage or filing of an affidavit of domestic partnership;
  • Divorce, filing of a termination of domestic partnership, legal separation or annulment;
  • Birth or adoption of a child;
  • Death of your spouse or dependent child;
  • Change in employment status for you or your spouse (such as starting a new job or stopping employment);
  • Gain or loss of coverage or change in eligibility for benefits (such as a change in work schedule that reduces or increases hours, a switch between part-time and full-time employment, start of, or return from, an unpaid leave);
  • Change of residence or work location for you or your spouse that affects your benefits (such as moving out of your HMO service area);
  • Gain or loss of eligibility for subsidy from Medicaid or CHIP (Children’s Health Insurance Program);
  • Gain or loss of coverage through Medicaid or CHIP;
  • Spouse’s Open Enrollment; and
  • Entitlement to or loss of eligibility for Medicare or Medicaid.

    Any change in benefit program or coverage must be consistent with the qualified event. For example, if you get married, you may add your spouse (and any eligible dependent children) to your medical plan, or you may cancel your medical coverage to join your spouse’s plan, but you may not change medical plans.

    To change a benefit election due to a qualified change in employment or family status, you must notify Human Resources and provide appropriate documentation, within 31 days of the date the status change takes place. If you do not make the change(s) within 31 days of the occurrence of the qualified event, you cannot change your benefits until the next Open Enrollment period.

    The effective date of your change in coverage is the date that your qualified change in status occurred.
 
 

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