Page 5 - 2019-2020 Country Financial Credit Union Benefit Booklet

Making Changes to the Insurance During the Plan Year

The Qualified Changes of Status below are allowable benefit changes made in accordance with the
Consistency Rule, Department of Labor Regulations, and the Employer’s Plan Document.

**Consistency Rule: In all cases, any election change as a result of any change in status must be on

account of and correspond with a change in status that affects eligibility for coverage under the
plan. For example, if the change in status is the employee’s divorce, annulment or legal separation
from a spouse, the death of a spouse or dependent child, or a dependent ceasing to satisfy the
eligibility requirements for coverage, an employee’s election to cancel health coverage will apply
only to the spouse involved in the divorce, annulment or legal separation, the deceased spouse or
dependent child, or the dependent that ceased to satisfy the eligibility requirements.

For a complete description of allowable election changes associated with Changes in Status, please
refer to the Plan Document.

1. What if I get married?

MEDICAL/DENTAL/VISION INSURANCE: If you get married, you can add your spouse to your medical, dental and/or vision
plan or if you wish to cancel your medical, dental and/or vision coverage and be added to your spouse's coverage, you can
make these changes within 30 days from the date of marriage.
VOLUNTARY LIFE INSURANCE: If you get married, you may elect Voluntary Life Insurance for your spouse, provided you are
already enrolled in the coverage. If electing over the Guarantee Issue Amount, an Evidence of Insurability (EOI) is required.
Please note: Elections received after the initial eligibility period will be subject to medical underwriting and require an
Evidence of Insurability (EOI).
Necessary documentation: Copy of marriage certificate submitted within 30 days to the HR Department.

Action Required: You have 30 days from the date of marriage to add your spouse or cancel medical, dental and/or vision
coverage, and/or Voluntary Life Insurance. If you do not submit the appropriate paperwork within the 30-day deadline,
you may be required to wait until the annual Open Enrollment to make these changes. Be sure to update your beneficiary
designation.

2. What if I have a baby/adopt a child?

MEDICAL/DENTAL/VISION INSURANCE: You have 30 days from the birth or adoption to add your newborn/child to your
medical, dental and/or vision insurance (even if you already have family coverage). The newborn will be covered
retroactive to the newborn’s birth date or the date you received custody of your adopted child.

VOLUNTARY LIFE INSURANCE: If you have a baby or adopt, you may elect Voluntary Life Insurance for your dependent.
Please note: Elections received after the initial eligibility period will be subject to medical underwriting and require an
Evidence of Insurability (EOI).
Necessary documentation: Copy of Birth Certificate, letter from the Hospital, or a copy of the adoption papers submitted
within 30 days to the HR Department.

Action Required: You have 30 days from the date of birth or adoption to add a baby to your medical, dental and/or vision
plan, and/or elect Voluntary Life Insurance. If you do not submit the appropriate paperwork within the 30-day deadline,
you may be required to wait until the annual Open Enrollment to make these changes. Be sure to update your beneficiary
designation.

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