The law permits a special enrollment period to change your elected coverage mid-year if you have a qualifying life/work event, provided you notify Businessolver within 31 days of the event. Examples of qualified life/work events include:
- Change in your legal marital status—marriage, death of spouse, divorce, legal separation, or annulment.
- Change in your number of dependents including:
- Birth or adoption of a child
- The placement of a child with you for adoption
- Your dependent child satisfying or ceasing to satisfy eligibility requirements for coverage
- The death of your dependent child or spouse
- A court order requiring you to provide coverage for a child under a Qualified Medical Child Support Order (QMCSO).
- Change in employment status:
- Your status,
- Your spouse, or
- Dependent child’s to include beginning or termination of employment
- Changing from a non-benefits-eligible to a benefits-eligible position or status.
- Loss or gain of coverage for you, your spouse or eligible dependents.
Note: IRS regulations specify that an employee must actually obtain coverage under the spouse’s or dependent’s plan for the election change to be consistent. Sufficient proof of coverage will be required.
- Significant change in coverage (e.g., a significant cost increase or reduction in coverage of your spouse’s benefits). Only the election for health plan coverage may be changed mid-year due to a change in the cost of coverage.
- When a child is no longer eligible due to age, coverage terminates the end of the month following the child’s 26th birthday.
The change you make must be consistent with the life/work event. If such an event occurs, you must make changes within 31 days of the qualifying event. You will need to provide proof of the change, such as a marriage certificate, record of birth, spouse’s employer information, etc.
Depending on the qualifying event, changes will become effective the first day of the month following the qualifying event. Coverage for newborns (including adopted children) is effective from the date of birth or adoption. Changes due to divorce become effective at the end of the month. Changes due to death become effective from the date of death.
Notify Businessolver at 844-436-7172 within 31 days of any qualifying event. If you don’t, you will not have the opportunity to make changes until the next Annual Enrollment period. All required documents must be returned to Businessolver within 31 days of the date you reported the change.
If a dependent no longer qualifies under the plan, (e.g. divorce or death, etc.) and you have not contacted Businessolver in a timely manner, the maximum premium refund you will be eligible to receive is up to three months.