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Qualifying Status Changes

Typically if an employee wants to make changes to a benefit plan, those changes can only be made during the annual Open Enrollment period. Exceptions are made for employees who experience a family or employment status change during the year.

According to IRS regulations, if you have a qualifying status change, you may change your medical, dental, flexible spending accounts, and/or life insurance benefits within 30 days of that qualifying change. You must make your change(s) through the online enrollment system and return the appropriate accompanying documentation within the 30-day limit to the HR Benefits Department, 443-997-5521 or visit Osler 7.

Qualifying changes include:

  • Marriage, divorce, legal separation or annulment
  • Birth, adoption, placement for adoption or appointment of legal guardianship of a child
  • Death of a dependent
  • Gain or loss of a dependent’s coverage
  • A change in your or your dependent’s employment status due to a switch between full-time and part-time, a strike or lockout, or an unpaid leave of absence
  • A significant change in the cost of coverage under a health plan provided by an independent, third-party provider
  • A significant change in your or your spouse’s medical care coverage that is related to your spouse’s employment
  • An unpaid leave of absence for you or your spouse under the Family and Medical Leave Act (FMLA)
  • A change in your dependent’s eligibility (e.g., due to being over the age limit)
  • A change in your or your dependent’s work site or residence, only if a change in residence will have an effect on benefits
  • A judgment, decree or order that requires you to cover a dependent
  • Your or your dependent’s eligibility for COBRA
  • Your or your dependent’s eligibility for Medicare or Medicaid (you may change the current election for the eligible person only)
  • Same-sex domestic partner can only become uninvolved for reason of ending relationship (affidavit needs to be signed by both parties)
  • Any other event that qualifies as a family status change under the Internal Revenue Code (with the approval of the plan administrator) to be consistent with the status change

You may only make benefits changes that are consistent with one of the qualifying family status changes listed above. You may change your level of medical coverage (i.e., yourself or family), but you may not change your medical plan.

 
 

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