Family Status Change - Life Events
What is a Family Status Change ?
A family status change is a life event that may allow an employee to add or drop coverage . The change must be consistent with the event and documentation must be provided to Human Resources within 30 days of the life event and / or family status change . Family status changes , other than birth and adoption , are effective the first of a month following receipt of required documentation . When a child gains or loses Children ’ s Health Insurance Program , also known as CHIP , employees have 60 days to provide documentation of the gain or loss of coverage to make a corresponding change to coverage ; adding or dropping coverage . Family status changes / life events cannot be updated in the Lawson system . Employee must contact Human Resources .
Eligible family status changes include marriage , divorce , birth , adoption , death , child reaching age 26 , child ’ s loss of eligibility on another plan , spouse ’ s gain or loss of other coverage . ( A child is terminated from medical , dental , and / or vision coverage the last day of the month he / she attains age 26 . All other plans end on the date the child is age 26 .)
Notification and Documentation Requirements
ADDING COVERAGE :
Marriage-A 1
Layoff-A 3
Loss of Coverage-A 3 Court Ordered Guardianship or Custody-A 2
Birth-A 1
DROPPING COVERAGE :
Divorce-B 2 / 5
Other Coverage-A 4 Dependent Child Maximum
Age-B 5
Dependent Daycare Added-A 4
Adoption-A 1 / 2
Placement for Adoption-A 1 / 2 Medicaid or CHIP loss of eligibility-B 3
Death-A 1
Daycare Discontinued-A 3 Medicaid or CHIP eligibility-B 4
LIFE EVENT DESCRIPTION CODES
A . Add / Drop required within 30 days of event . B . Add / Drop required within 60 days of event .
1
Provide marriage / birth / death certificate within 30 days of event as applicable .
2
Provide Court document signed by judge .
3
Provide proof of loss of coverage .
4
Provide proof of coverage or enrollment .
5
Provide address when dropping former spouse or provide address for dependent child reaching maximum age of 26 .
NOTE : A family status change allows a plan change – i . e ., Exclusive Provider Plan ( EPO ) to High Deductible Health Plan ( HDHP ). Plan changes may impact year-to-date deductible , co-insurance and / or copays . Example : Employee + Spouse coverage level changed to Employee Only coverage level . Only the claims incurred by the employee would follow the new Employee Only coverage level .
All payroll deductions / refunds due resulting from plan changes will be taken on the next paycheck . Deductions and refunds are based on the effective date of the change when enrollment and documentation are timely provided to HR .
Enrollment for ‘ future life events ’ is not allowed . Example : Marriages that have not yet taken place and / or children that have not yet been born are not eligible for enrollment until the date of the actual life event ( marriage / birth , etc .) Contact Human Resources for additional information .)
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