Page 14 - 2016 Enrollment
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Making Changes (Qualifying Life Events)
The Internal Revenue Service Departure for or return from an FMLA-qualiied unpaid leave of
(IRS) regulations provide that absence (you or your spouse)
eligible employees may only make A residence or worksite change that impacts healthcare coverage
beneit elections once a year;
annual enrollment beneit choices Judgment, court order, or decree requiring coverage, including
are binding through December 31, qualiied medical child support orders
2016 (applies to medical, dental, Change in dependent care provider or to cost of dependent care
vision, and FSA coverages). Termination of coverage under a Medicaid plan or Children’s Health
Insurance Program (CHIP) due to loss of eligibility (request for
The following special coverage must be made no later than 60 days after the date coverage
circumstances allow for a change terminates)
in beneits during the year (not
inclusive): Eligibility for a Medicaid or CHIP premium-assistance subsidy for
qualiied employer-sponsored health coverage (request for coverage
Marriage, divorce, or legal must be made no later than 60 days after eligibility for the subsidy)
separation These special circumstances, often referred to as life event changes, will
Birth, adoption, or placement allow you to make plan changes at any time during the year in which
of a child for adoption they occur. For any allowable changes, you must inform the beneits
Child no longer qualiies as an department within 30 calendar days of the event. The effective date of
eligible dependent any requested change(s) will be the later of the date of the qualifying
Termination or event or the date the request for changes was made. Changes that are
commencement of your requested due to a “change of mind” cannot be allowed until the next
spouse’s coverage in general annual enrollment period.
when coverage is maintained
through the spouse’s plan The 30 calendar day deadline is a critical factor towards successfully
(e.g., spouse begins or ends completing a life event change. If you do not notify Beneits Team of the
employment) event and provide requested documentation within 30 calendar days of
the event, you will not be eligible to make changes until the next annual
Shift from part-time to full- enrollment period unless you experience another qualifying life event.
time status (or vice versa) by
you or your spouse
Death of spouse or dependent
Thompson Coburn LLP
Making Changes (Qualifying Life Events)
The Internal Revenue Service Departure for or return from an FMLA-qualiied unpaid leave of
(IRS) regulations provide that absence (you or your spouse)
eligible employees may only make A residence or worksite change that impacts healthcare coverage
beneit elections once a year;
annual enrollment beneit choices Judgment, court order, or decree requiring coverage, including
are binding through December 31, qualiied medical child support orders
2016 (applies to medical, dental, Change in dependent care provider or to cost of dependent care
vision, and FSA coverages). Termination of coverage under a Medicaid plan or Children’s Health
Insurance Program (CHIP) due to loss of eligibility (request for
The following special coverage must be made no later than 60 days after the date coverage
circumstances allow for a change terminates)
in beneits during the year (not
inclusive): Eligibility for a Medicaid or CHIP premium-assistance subsidy for
qualiied employer-sponsored health coverage (request for coverage
Marriage, divorce, or legal must be made no later than 60 days after eligibility for the subsidy)
separation These special circumstances, often referred to as life event changes, will
Birth, adoption, or placement allow you to make plan changes at any time during the year in which
of a child for adoption they occur. For any allowable changes, you must inform the beneits
Child no longer qualiies as an department within 30 calendar days of the event. The effective date of
eligible dependent any requested change(s) will be the later of the date of the qualifying
Termination or event or the date the request for changes was made. Changes that are
commencement of your requested due to a “change of mind” cannot be allowed until the next
spouse’s coverage in general annual enrollment period.
when coverage is maintained
through the spouse’s plan The 30 calendar day deadline is a critical factor towards successfully
(e.g., spouse begins or ends completing a life event change. If you do not notify Beneits Team of the
employment) event and provide requested documentation within 30 calendar days of
the event, you will not be eligible to make changes until the next annual
Shift from part-time to full- enrollment period unless you experience another qualifying life event.
time status (or vice versa) by
you or your spouse
Death of spouse or dependent
Thompson Coburn LLP
