Changing Benefit Options
Changing Benefits Mid-Year - Qualifying Events
Examples of qualifying events are getting married, having a baby, adopting a child or involuntarily losing coverage on a spouse's or another insurance plan.
Within 31 days of the effective date of a qualifying life event, benefit eligible employee may elect insurance, or add/remove dependents from the employee's current plan. Additional documentation will be required for any qualifying event to show the event occurred. You have up to 45 days from the date of the event to provide proof of the event and any dependent verification documentation.
The state does not prorate the premiums. All changes are effective the first of the month following the date of the event or the date of entry into the benefits system, whichever is later with the exception of births or adoptions which are effective the date of the event itself.
In the event of a divorce, legal separation or a child reaching the age of 26 (the month in which they turn 26), participants are no longer eligible to keep the ex-spouse or an ineligible dependent on the plan. They are eligible to receive benefits until the end of the month in which they no longer meet the eligibility requirement.
Employees are responsible for notifying the Human Resource Office/Benefits Administration of these events. COBRA notification will be sent upon notice of loss of coverage. If changes are not entered within the 31-day requirement, you will be required to wait until the next open enrollment for the following plan year.
Open Enrollment
Changes can be made to plans during the annual Open Enrollment for benefits. Open Enrollment typically occurs in the Spring with plan changes going into effect on July 1st. The types of changes that can be made include:
Changing to a different plan
Adding or dropping coverage
Adding or dropping dependents
Changing premium withholding designations (i.e. pre-tax/post-tax)
Please note, this is the only time when plan changes can be made with the exception of certain situations called Qualifying Events.