Description
If you or a dependent lose coverage under any other group insurance plan, or if you acquire a new dependent during the plan year, the federal Health Insurance Portability and Accountability Act (HIPAA) may provide additional opportunities for you and eligible dependents to enroll in health coverage. If you are adding dependents to your existing coverage, you and eligible dependents may transfer to a different carrier or healthcare option, if eligible. You or eligible dependents may also be eligible to enroll in dental and vision coverage if you meet the requirements stated in the dental or vision certificates of coverage. Premiums are not prorated. If approved, you must pay premium for the entire month in which the effective date occurs.
Eligibility
- An event causing the loss of eligibility for coverage from another group health insurance plan.
- An event that results in acquisition of a new dependent spouse or stepchild acquired by marriage, or a child acquired pursuant to an order of guardianship.
- An event that results in acquisition of a new dependent acquired by birth, adoption, or placement in legal custody for adoption.
Not Eligible:
- Voluntary actions resulting in loss of coverage (such as voluntary cancellation of coverage and cancellation for not paying premiums) are not qualifying events.
- Electing to cancel, waive or decline coverage during another plan’s enrollment period is not a qualifying event.
Deadlines for Enrollment Change
Application for enrollment must be made within 60 days of the loss of eligibility for other health insurance coverage or within 30 days of a new dependent’s acquire date.
Effective Date of Coverage
Required Forms
2023 Enrollment Change Form with Basic Term Life Insurance
Supporting documentation confirming qualifying event and dependent eligibility
Optional Forms
2023 Voluntary AD&D
Optional Term Life (online enrollment)
Related Policies
2023 New Hire Insurance and Eligibility Guide