Qualifying Life Events & Group Insurance Coverage

questions and answers2What is a Qualifying Life Event?

During the plan year, you can change your benefit coverage if a qualified change in status affects you or your dependents’ eligibility under your employer’s plans. If you’re eligible to make coverage changes, your changes must be consistent with the change in status. They must also match any changes your spouse or child makes to his or her coverage under another employer’s plans. Below are the situations that qualify as a change in status.

Your legal marital status changes:

Marriage
Divorce, legal separation, or annulment
Death of your spouse

The number of your eligible children changes:

Birth or adoption of a child
Child gains or loses eligibility for coverage under the plan
Death of a child

Your benefits eligibility changes because of:

Taking or returning from a leave of absence
A change in work schedule or status that causes you to gain or lose eligibility

Your family member’s benefits eligibility changes because of a change in his or her eligibility or coverage under another employer’s plans:

A change in work schedule or status that causes him or her to gain or lose eligibility
He or she gains a benefit option or loses coverage
He or she makes new coverage choices during his or her employer’s annual enrollment
Your or your family member’s COBRA coverage from another employer expires
You or your family member becomes eligible for or loses Medicare or Medicaid
You or your family member loses coverage under a government’s or educational institution’s plan

Election Changes Due to Status Changes
You may change your coverage elections in accordance with the special enrollment rights provided under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Group health plans and health insurance issuers are required to provide special enrollment periods during which individuals who previously declined coverage for themselves and their dependents may be allowed to enroll (without having to wait until the plan’s next open enrollment period). You may change coverage levels mid-year, but you may not change that plans that you are currently enrolled in mid-year.

Source: https://www.humana.com/insurance-through-employer/enrollment-center/life-changing-events

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