Page 5 - ProModel 2015 Benefits Guide
P. 5
PLAN ELIGIBILITY
Qualified Family Status Change
You may only make changes to your choices during the calendar year
if you have a qualifying family status change. Qualiied family status
changes include the following.
Marriage, death of a spouse, divorce, legal separation, or annulment
Birth, placement for adoption, adoption of a child, or a court issues
a Qualiied Medical Child Support Order (QMCSO) requiring the
plan to provide medical coverage for your dependent child
Change in your spouse’s or dependent’s employment status
including termination, change from full-time to part-time (or vice
versa), or unpaid leave of absence
Your dependent loses coverage under any group health plan
Signiicant change in the cost of your current coverage or the
options being offered
Death of a covered dependent
Your spouse’s employer’s medical plan, in which you are currently
enrolled, ceases its contributions to the plan’s cost or has an open
enrollment (does not apply to FSA)
A dependent becomes eligible or ineligible for coverage, which
could put you in a different coverage category
If you experience a Qualiied Family Status Change, you must notify
Human Resources within 31 days of the change. Depending on
the type of change, you may need to provide proof of the change. It is
your responsibility to notify Human Resources when a dependent is no
longer eligible for beneit coverage.
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Qualified Family Status Change
You may only make changes to your choices during the calendar year
if you have a qualifying family status change. Qualiied family status
changes include the following.
Marriage, death of a spouse, divorce, legal separation, or annulment
Birth, placement for adoption, adoption of a child, or a court issues
a Qualiied Medical Child Support Order (QMCSO) requiring the
plan to provide medical coverage for your dependent child
Change in your spouse’s or dependent’s employment status
including termination, change from full-time to part-time (or vice
versa), or unpaid leave of absence
Your dependent loses coverage under any group health plan
Signiicant change in the cost of your current coverage or the
options being offered
Death of a covered dependent
Your spouse’s employer’s medical plan, in which you are currently
enrolled, ceases its contributions to the plan’s cost or has an open
enrollment (does not apply to FSA)
A dependent becomes eligible or ineligible for coverage, which
could put you in a different coverage category
If you experience a Qualiied Family Status Change, you must notify
Human Resources within 31 days of the change. Depending on
the type of change, you may need to provide proof of the change. It is
your responsibility to notify Human Resources when a dependent is no
longer eligible for beneit coverage.
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