Page 7 - Dragados 2022 Benefits Guide

Qualified Life Status Changes
If you decline medical, dental or vision coverage for yourself/your family, you cannot re-join our plans until the next annual enrollment period unless a qualified life status change occurs such as:
• Marriage, divorce, legal separation or annulment.
• Birth, adoption, placement for adoption or death.
• Changes in employment status of you or your spouse/dependent.
• A dependent satisfies or ceases to satisfy eligibility requirements.
• A change in residence in or outside of the plan service area of the employee, spouse, or dependent.
• Your spouse’s annual enrollment with his or her employer.
• Judgment, decree or court order resulting from divorce, legal separation, annulment or change in legal custody requiring the employee to provide coverage for a dependent child, including a Qualified Medical Child Support Order (QMCSO).
• A change in your spouse’s or your dependent’s entitlement to Medicare
or Medicaid.
• There is a significant change in the cost or coverage of health benefits (this does not apply to FSAs).
The election change must be consistent with the status change. To amend your elections because of a qualified change in status, you must notify HR within 31 days of the status change.
If you decline supplemental life, for yourself or your family, you must submit Evidence of Insurability to enroll in coverage outside of your initial 31-day enrollment period (unless there is a qualified Life Status Change).
Special Enrollment
If you are declining enrollment for yourself or your dependents (including your spouse or domestic partner) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in the plan, provided that you request enrollment within 31 days after your other coverage ends (COBRA or state continuation coverage ends, divorce, legal separation, death, termination of employment or reduction in hours worked; or because the employer contributions cease).
In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 31 days after the marriage, birth, adoption or placement for adoption. If you or your dependent lose coverage under a Medicaid Plan or Children’s Health Insurance Program (CHIP), or become eligible for group health plan premium assistance under a Medicaid Plan or under the CHIP, you may request enrollment within 60 days after coverage under the Medicaid or CHIP ends or within 60 after you or your dependent is determined to be eligible for state premium assistance under CHIP.
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