Sorry, you need to enable JavaScript to visit this website.

Frequently Asked Questions

    What are Qualified Change of Status Events?

    Answer:

    The benefit elections you make as a new hire or during Annual Enrollment will stay in effect for the entire plan year if you remain eligible for benefits. Each year, during the Annual Enrollment period, you have an opportunity to change your coverage elections for the following year. However, after Annual Enrollment ends, you can make changes to your health care and FSA coverage ONLY if they are on account of and consistent with a qualified change ofstatus as defined by the Internal Revenue Service. Qualified status changes include:

    • Marriage or registration of a domestic partner

    • Divorce or separation from a registered domestic partner

    • Birth or adoption of a child

    • Death of a spouse/registered domestic partner or a child
    • Change in your spouse/registered domestic partner’s employment

    • Significant changes in your spouse/registered domestic partner’s employer’s medical coverage

    • Child’s loss of eligibility due to age or marital status

    • Full-time/part-time employment status change that results in an insurance eligibility change

    • You, your spouse, or your dependent child becomes eligible for Medicare or Medicaid

    • A judgement, decree, or court order requires a coverage change

    • Commencement of or return from an unpaid leave of absence Most status changes are easy to manage.

    Simply complete a Benefit Election Form and return it to your department representative within 60 days after the event that caused the status change. You must include documentation of the event (such as a marriage license). Most changes are made prospectively from the date that Human Resources receives a properly completed and signed Benefit Election Form. Exceptions are made for birth or adoption to comply with the special enrollment rights defined under the Health Insurance Portability and Accountability Act.

    What is the Consistency Rule?

    Answer:

    There is a special “Consistency Rule” that applies to these change-of-status events: Any change to your elections must be on account of and consistent with the event. For example, if your dependent loses eligibility for coverage you may cancel health coverage only for that dependent. Or, if you get married you may add your new spouse and any eligible step-children to currently elected plans, but you may not elect to change health plans.

    How long do I have to make the change?

    Answer: You have 60 days after the day of the event to a make your change. Simply complete a Benefit Election Form and return it to your department representative within 60 days after the event that caused the status change. You must include documentation of the event (such as a marriage license, birth certificate etc.). Most changes are made prospectively from the date that Human Resources receives a properly completed and signed Benefit Election Form. Exceptions are made for birth or adoption to comply with the special enrollment rights defined under the Health Insurance Portability and Accountability Act.

    What kind of supporting documentation do I need?

    Answer:

    You must provide documentation to support your election change by documenting the change-of-status event that you base your election change. The documentation must show the date of the event. Some examples of appropriate documentation are:

    Change-of-Status Event

    Example of Documentation

    Marriage

    Marriage certificate of Affidavit of Marriage

    Registration of Domestic Partner

    Copy of the Declaration of Domestic Partnership accepted by the Secretary of the State.

    Divorce

    A copy of your finalized divorce decree

    Birth of a child

    Birth Certificate, the hospital certificate may be used temporarily to add the child until the Birth Certificate is obtained.

    Adoption

    Copies of the adoption papers

    Death of a Spouse of Dependent

    Copy of the Death Certificate

    A judgment, decree or court order

    A copy of the judgment, decree or court order

    Why doesn't the county allow me to make election changes whenever I want?

    Answer:

    The County’s ability to allow employees to cancel or change health plan elections is governed by the Internal Revenue Code and by health plan carrier contracts. The County’s policies to grant mid-year changes are established to conform to these requirements.

    Section 125 of the Internal Revenue Code (IRC) governs how employers provide benefits to employees on a pre-tax basis. After an employee has made an initial enrollment election, outside of Annual Enrollment, Section 125 does permit changes except for certain, specific reasons. The permitted Section 125 changes are the qualified “change-of-status” events described above. (This booklet is provided to all eligible employees every year during annual enrollment.

    Unfortunately the County is required to follow this Internal Revenue Code Section consistently or ALL County employees could become immediately responsible for paying taxes on benefits. To insure that this does not occur, the County adheres to the requirements of Section 125 for the protection of all employees.

    The County’s carrier contracts are written to comply with IRC section 125 and they govern when an enrollment change will be accepted and the effective date of the change. Outside of the annual open enrollment period, changes are only accepted for Section 125 permitted mid-year changes.

    Ask a Question

    When is Open Enrollment?

    Answer: Open Enrollment occurs each fall for coverage beginning January 1st of the following plan year.  The exact dates may vary, but generally the period for Active employees is September and Retired employees in October.