Generally, employees may enroll or make changes in their health and dental coverage only when first hired by the College. However, certain changes can be made at other times when you experience an IRS qualifying “life event.”
Employees are responsible for notifying the Human Resources Office within 30 days of a “life event” to request a change of coverage (i.e., add/remove a dependent), or to request a mid-year election change under a PayFlex flexible spending account. The change requested must be consistent with the “life event” that has taken place.
A qualifying “life event” includes:
- Marriage, divorce, legal separation, or spouse’s death
- Birth, adoption, or death of a dependent
- Loss of your spouse’s insurance coverage
- Change in employee or spouse’s employment status or change in work schedule (i.e., switch from part time to full time or return from leave without pay)
- Loss of dependent status (limiting age of dependent; age 26 for health/dental insurance)
- Change in place of residence or work and plan not available there
- Entitlement or loss of eligibility for Medicare or Medicaid
- Judgment, decree or order from a divorce, legal separation or change in custody
- Significant change in cost or coverage of employee or spouse’s insurance
- Spouse’s employer’s open enrollment period
The HIPAA (Health Insurance Portability & Accountability Act) law (62 Federal Register 16979) requires employers to provide certification of health coverage, upon the request of the employee, in order to obtain coverage through another employer group health plan upon termination of employment or when a spouse is enrolling in a new health plan. Special enrollees may be subject to up to a 12-month waiting period before pre-existing health conditions are covered; however, this waiting period may be reduced if the employee furnishes BCBS with a Certificate of Creditable Coverage, provided there is no gap in coverage of longer than 62 days.
HR Contact: Julie Nohrenberg, 402-457-2232