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Special Enrollments

Every year an employer health plan will go through an open enrollment period.  What happens, however, when an employee has a qualifying life event outside of that timeframe?  Employees can make changes to their health plan when they have a qualifying life event under HIPAA special enrollment rights.

Special enrollment generally means that the employee or dependent will have the right (within insurance contract timeframes) to request coverage in your group health plan, regardless of your open enrollment period.  The examples listed below are basic life events that could open up as a special enrollment period for the employee.

  • marriage or divorce
  • the death of the employee’s spouse or dependent
  • change in dependency status
  • birth or adoption of a child of the employee
  • termination of employment
  • commencement of employment, of the employee’s spouse
  • switching from part-time to full-time, or from full-time to part-time status by the employee or the employee’s spouse
  • court orders with specific instructions for health insurance
  • loss of other insurance coverage for employee, spouse or dependents.

 

At Haren Insurance, we help walk our employers through these special enrollment rights and responsibilities.  Does your current broker offer the same type of support and service?