Changes outside of Open Enrollment

New Coverage:

Newly eligible employees (i.e., changing from less than half-time to half-time or more assignments or returning from long-term, unpaid leave of absence) may enroll for coverage by submitting appropriate enrollment forms with supporting documentation for eligible dependents to the Employee Benefits Department within 31 days of becoming eligible.

Newly eligible dependents (i.e., marriage, registration of same-sex domestic partnership, birth, adoption, or placement for adoption, legal guardianship) may be added to your coverage by submitting appropriate enrollment forms with supporting documentation for eligible dependents to the Employee Benefits Department within 31 days of the qualifying event.

When an employee or a dependent does not enroll for district health coverage because he/she has other coverage, a federal law known as HIPAA (Health Insurance Portability and Accountability Act) permits enrollment at times other than Open Enrollment when loss of the other coverage occurs. An appropriate enrollment application with supporting documentation for eligible dependents must be submitted to the Employee Benefits Department within 31 days following the loss of other coverage provided the loss is through no fault of the dependent. This special enrollment provision also allows an employee to enroll for coverage for self/dependents within 31 days of acquiring a new dependent (i.e., marriage, birth, adoption, or placement for adoption).

Dependent Eligibility Verification Requirements

Ending Coverage:

Employees are responsible for dis-enrolling any dependent who loses eligibility for coverage (e.g. divorce, termination of domestic partnership, death) within 31 days of the dependent's eligibiilty status change.  In many cases, dependents losing coverage will be entitled to continue coverage on a self-pay basis under COBRA (Consolidated Omnibus Reconciliation Act).  Regardless of the timing of notice to the district, coverage for an ineligible dependent will end on the last day of the month in which the member loses eligibility (subject to any continued coverage option available and elected).