Page 3 - 2016 Enrollment
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Qualified Family Status Change Eligibility
You may make changes to your coverage elections at Open Enrollment, You may enroll if you are a full-time
or during the calendar year only if you have experienced a Qualiied active employee working a minimum of
Family Status Change, such as the following. 30 hours or more per week on average.
X Marriage, death of a spouse, divorce, legal separation, or Eligible dependents include your legal
annulment spouse and your children up to age 26
(natural, stepchildren, foster children,
X Birth, placement for adoption, adoption of a child, or a court adopted children, or any child you
issued Qualiied Medical Child Support Order (QMCSO) requiring have legal custody of). Children will be
the plan to provide medical coverage for your dependent child covered on the medical plan until the
end of the month in which they turn
X Change in your spouse’s or dependent’s employment status age 26.
including termination, change from full-time to part-time (or vice
versa), or unpaid leave of absence
X Your dependent loses coverage under any group health plan
X Signiicant change in the cost of your current coverage or the options being
offered
X Death of a covered dependent
X 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)
X 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.
Spousal Employer Coverage Certification
Ronnoco is committed to offering a comprehensive beneit package to you and your family
but also realizes many spouses have medical coverage available to them through their own
employer. For this reason, spouses with medical coverage through their employer will be
required to take that coverage.
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You may make changes to your coverage elections at Open Enrollment, You may enroll if you are a full-time
or during the calendar year only if you have experienced a Qualiied active employee working a minimum of
Family Status Change, such as the following. 30 hours or more per week on average.
X Marriage, death of a spouse, divorce, legal separation, or Eligible dependents include your legal
annulment spouse and your children up to age 26
(natural, stepchildren, foster children,
X Birth, placement for adoption, adoption of a child, or a court adopted children, or any child you
issued Qualiied Medical Child Support Order (QMCSO) requiring have legal custody of). Children will be
the plan to provide medical coverage for your dependent child covered on the medical plan until the
end of the month in which they turn
X Change in your spouse’s or dependent’s employment status age 26.
including termination, change from full-time to part-time (or vice
versa), or unpaid leave of absence
X Your dependent loses coverage under any group health plan
X Signiicant change in the cost of your current coverage or the options being
offered
X Death of a covered dependent
X 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)
X 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.
Spousal Employer Coverage Certification
Ronnoco is committed to offering a comprehensive beneit package to you and your family
but also realizes many spouses have medical coverage available to them through their own
employer. For this reason, spouses with medical coverage through their employer will be
required to take that coverage.
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