桃瘾社区

Choate House on the 桃瘾社区 Pleasantville campus

Changes in Family Status

Under the 桃瘾社区 group health plans and Flexible Spending Accounts, employees and their eligible dependents may enroll when they first become eligible for coverage and annually during the Open Enrollment period. When you enroll in benefits, your elections remain in effect to the end of the calendar year (December 31st) and changes to your election are not permitted until the next Open Enrollment period. Open Enrollment is typically conducted in late October or early November for an effective date of January 1st. However, if you experience a qualifying change in family status during the plan year, you may be eligible to make a mid-year change to your benefits that corresponds with the life-changing event. See the Family Status Changes Chart below for a list of qualifying events.

Enrollment and Effective Dates

To change your coverage when a qualifying life event occurs, you must notify the University Benefits office within 31 days of the date of the qualifying event for the anticipated change to be considered. Once the 31 day-timeframe expires, you are only able to make a change during the next annual Open Enrollment period. Changes made during Open Enrollment are effective as of January 1st.

In most cases, the effective date of the enrollment/termination is the 1st of the month following the date of the qualifying event. However, in some situations (birth of a child), the effective date is the same date the actual life event occurred.

In addition to the completion/submission of certain benefits forms, you must provide documentation to support the type of qualifying change as well as the effective date. You must also provide a marriage certificate to add your spouse to the health plans and birth certificates to add your dependent children. Copies of Social Security cards are required for all dependents.

Family Status Changes

Change in Employee's Marital Status

Marriage/Domestic Partnership

Healthcare Plan Coverage Options:

  • Can enroll spouse/domestic partner (and any eligible affected children) in the plan
  • Can drop coverage and join your spouse's employer health plan

Plan Changes Options:

  • May change medical/dental plan

Required Documentation:

Marriage:

  • Marriage License

Domestic Partner:

Divorce, Legal Separation, Annulment, Termination Domestic Partnership

Healthcare Plan Coverage Options:

  • Add coverage, including children (if lost coverage under spouse's/domestic partner's plan).
  • Eliminate coverage for spouse/domestic partner

Plan Changes Options:

  • May change medical/dental plan

Required Documentation:

  • Letter of Proof Coverage Terminated (Copy of Legal Documentation) Notarized statement from employee stating that domestic partnership has ended.

Death of Spouse

Healthcare Plan Coverage Options:

  • Add coverage, including children (if lost under spouse's plan).
  • Eliminate coverage for spouse

Plan Changes Options:

  • TBD

Required Documentation:

  • Certified Death Certificate

Increase in Number of Dependents

Birth, Adoption or Placement for Adoption

Healthcare Plan Coverage Options:

  • Add new child only.
  • Add spouse (if applicable).

Plan Changes Options:

  • May change medical/dental plan

Required Documentation:

  • Birth Certificate - as soon as available
  • Copy of Social Security Card - as soon as available
  • Adoption/Placement - Copy of guardianship letter from attorney/adoption agency
  • Marriage License (if adding spouse)

Decrease in Number of Dependents

Reaching Limiting Age

Healthcare Plan Coverage Options:

  • Eliminate child's coverage

Plan Changes Options:

  • TBD

Required Documentation:

Healthcare Plan Coverage Options:

  • Eliminate child's coverage

Plan Changes Options:

  • TBD

Required Documentation:

  • Death Certificate

Change in Employment (Spouse or Dependent)

Commence New Job - Gain Medical Plan Coverage Eligibility with Spouse's/Domestic Partner's new employer

Healthcare Plan Coverage Options:

  • Drop coverage for self and family to enroll in new employer's plan

Plan Changes Options:

  • TBD

Required Documentation:

  • Proof of Coverage through New Employer

Spouse/Domestic Partner Terminates Employment - Loss of Medical Plan Coverage with Spouse's Former Employer

Healthcare Plan Coverage Options:

  • Elect coverage
  • Add dependents to plan

Plan Changes Options:

  • Select medical/dental plan

Required Documentation:

Retire - May be eligible for coverage under "Rule of 75" ~ contact University Benefits office for review of your eligibility Ext. 22828.

Healthcare Plan Coverage Options:

  • Drop or add spousal coverage based on eligibility

Plan Changes Options:

  • Select medical plan

Required Documentation:

  • Per instructions from Benefits Office

Other Plan Annual Enrollment (Spouse or Dependent)

Annual Open Enrollment - Eligible for Other Coverage through Spouse/Domestic Partner on Different Plan Year

Healthcare Plan Coverage Options:

  • Drop coverage for self and family members thereby enrolling in dependent's coverage.
  • Elect coverage/add dependents to employee's plan who were previously covered under another plan

Plan Changes Options:

  • Select medical plan

Required Documentation:

  • Proof of Coverage Letter from spouse/domestic partner's employer

Legal Proceedings

Court Order, Judgment or Decree

Healthcare Plan Coverage Options:

  • Adhere to Court Order

Plan Changes Options:

  • Based on Court Order

Required Documentation:

  • Letter of Proof Coverage Terminated (Copy of Legal Documentation)