Page 20 - SIH 2022 Re-Enrollment Guide
P. 20
CHANGES ALLOWED DUE TO CHANGE IN FAMILY
STATUS EVENT
Life, AD&D, and Disability Dependent Care Spending
Medical, Dental, and FSA
Insurance Account
Marriage, Birth, or Adoption
X See HIPAA special enrollment rights for medical coverage
X You may add your new spouse or newly acquired dependent child to You may increase or decrease
your current medical and dental coverage You may either increase or your election if the event
X You may increase your FSA deposit decrease your coverage afects your dependent care
X You may drop SIH coverage if you enroll for coverage under your expenses
new spouse’s plan
You may increase or decrease
X You must drop coverage for the afected family member You may either increase or your election if the event
X You may decrease your FSA deposit decrease your coverage afects your dependent care
expenses
Change in the Employment Status of SIH Employee (e.g., change between full-time to part-time)
X You may add SIH coverage if your premium contributions decrease You may increase or decrease
X You may drop SIH coverage if your premium contributions increase You may either increase or your election if the event
X You may change your FSA deposit if the event afects eligibility for decrease your coverage afects your dependent care
expenses
medical coverage
Dependent Loses Beneit Eligibility (reaches limiting age)
X You must drop the afected family member’s coverage You may decrease your
X You may increase your FSA deposit if the family member remains deposit if your dependent
eligible under FSA N/A ceases to be eligible under
X You may decrease your FSA election if the family member no longer Dependent Care Spending
Account (DSA)
qualiies under FSA
Loss of Other Medical Coverage by Employee, Spouse, or Child(ren)
X See HIPAA special enrollment rights for medical coverage N/A N/A
Employee or Dependent Becomes Eligible or Loses Eligibility to Medicare or Medicaid
X See HIPAA special enrollment rights for medical coverage
X You may drop coverage upon enrollment for Medicare or Medicaid N/A N/A
X You may enroll for coverage upon loss of Medicare or Medicaid
eligibility
Court Issued Order Regarding Medical Coverage of a Child (qualiied medical child support order)
X You may enroll yourself and/or the child in the plan and increase
your FSA deposit if you are required to provide coverage
X You may drop coverage or reduce your FSA deposit if another N/A N/A
individual is ordered to provide coverage
Enrollment Period for Coverage Under Another Occurs While Your Beneit Choices are in Efect
You may make beneit
X You may drop your coverage if you or a family member becomes changes which correspond You may decrease your
covered under the other employer’s plan with coverage choices made deposit if your spouse chooses
coverage under an FSA
X You may not change your FSA deposit under the other employer’s ofered by his/her employer
plan
20
STATUS EVENT
Life, AD&D, and Disability Dependent Care Spending
Medical, Dental, and FSA
Insurance Account
Marriage, Birth, or Adoption
X See HIPAA special enrollment rights for medical coverage
X You may add your new spouse or newly acquired dependent child to You may increase or decrease
your current medical and dental coverage You may either increase or your election if the event
X You may increase your FSA deposit decrease your coverage afects your dependent care
X You may drop SIH coverage if you enroll for coverage under your expenses
new spouse’s plan
You may increase or decrease
X You must drop coverage for the afected family member You may either increase or your election if the event
X You may decrease your FSA deposit decrease your coverage afects your dependent care
expenses
Change in the Employment Status of SIH Employee (e.g., change between full-time to part-time)
X You may add SIH coverage if your premium contributions decrease You may increase or decrease
X You may drop SIH coverage if your premium contributions increase You may either increase or your election if the event
X You may change your FSA deposit if the event afects eligibility for decrease your coverage afects your dependent care
expenses
medical coverage
Dependent Loses Beneit Eligibility (reaches limiting age)
X You must drop the afected family member’s coverage You may decrease your
X You may increase your FSA deposit if the family member remains deposit if your dependent
eligible under FSA N/A ceases to be eligible under
X You may decrease your FSA election if the family member no longer Dependent Care Spending
Account (DSA)
qualiies under FSA
Loss of Other Medical Coverage by Employee, Spouse, or Child(ren)
X See HIPAA special enrollment rights for medical coverage N/A N/A
Employee or Dependent Becomes Eligible or Loses Eligibility to Medicare or Medicaid
X See HIPAA special enrollment rights for medical coverage
X You may drop coverage upon enrollment for Medicare or Medicaid N/A N/A
X You may enroll for coverage upon loss of Medicare or Medicaid
eligibility
Court Issued Order Regarding Medical Coverage of a Child (qualiied medical child support order)
X You may enroll yourself and/or the child in the plan and increase
your FSA deposit if you are required to provide coverage
X You may drop coverage or reduce your FSA deposit if another N/A N/A
individual is ordered to provide coverage
Enrollment Period for Coverage Under Another Occurs While Your Beneit Choices are in Efect
You may make beneit
X You may drop your coverage if you or a family member becomes changes which correspond You may decrease your
covered under the other employer’s plan with coverage choices made deposit if your spouse chooses
coverage under an FSA
X You may not change your FSA deposit under the other employer’s ofered by his/her employer
plan
20
