Page 6 - ABC Company Burnham Sample Guide

Changes to enrollment

Open Enrollment
During our annual open enrollment period, you may make new benefit elections for the following January 1st
effective date.

Qualifying Event
Once you make your benefit elections, you cannot change them throughout the year unless you experience a
qualifying event as defined by the IRS. Examples include, but are not limited to:

MarABC Companyge, Birth, adoption, or death Qualified Medical Child Change in your
divorce, legal separation, of a child or spouse Support Order (QMCSO) dependent’s eligibility
or annulment status

Loss of coverage from Change in your residence Loss of coverage through Eligibility for a state’s
another health plan or workplace (if your Medicaid or Children’s premium assistance
benefit options change) Health Insurance Program program under Medicaid
(CHIP) or CHIP

Coverage for a new dependent is not automatic. If you experience a qualifying event, you have 30 days to update
your coverage. Please contact the Human Resources Department immediately following a qualifying event to
complete the appropABC Companyte election forms as needed. You may login to Ease to update your dependent
information as needed. Ease login information is located on page X of this guide. If you do not update your
coverage within 30 days of the qualifying event, you must wait until the next annual open enrollment period to
update your coverage.