Health Insurance - Change Your Coverage

Changing Coverage

There are restrictions on when you can change your GSEHP coverage outside of the open enrollment period.  If your coverage is paid for on a pretax basis, you may only make changes at other times during the year if you have a special enrollment right or other qualifying event.  Generally, your benefits are paid for on a pretax basis unless you waive this arrangement; however, coverage of a same-sex spouse or domestic partner can only be deducted on an after-tax basis, unless he or she is a "qualifying relative" under section 152(d) of the Internal Revenue Code. Coverage paid for with after-tax contributions may be changed at any time during the year.

Qualifying Events

A qualifying event is a change in an employee's or dependent's status that permits a change to be made in pretax health insurance elections outside of the annual open enrollment period. The change in status must result in a gain or loss of coverage or coverage options. The election change must be consistent with the change in status.

Qualifying events include:

• Qualification for special enrollment rights - refer to Special Enrollment Rights in the Benefits Handbook for more information. 
• Change in legal marital status  - you are married, divorced, legally separated; your marriage is annulled; you add a domestic partner or end a domestic partner relationship.
• Change in number of dependents - you or your spouse gives birth or adopts a child; a child is placed with you for adoption; your child or spouse or domestic partner dies.
• Change in your or your spouse's employment status - you leave the RF or begin work for the RF; your spouse leaves his or her employer or begins a new job.
• Change in dependent eligibility - your child becomes eligible or loses eligibility as defined by the plan.
• Change in health coverage - the cost or coverage of benefits available to you or your spouse or domestic partner through the RF or another employer changes significantly.
• Change in work status - you or your dependent change jobs, or begin or end a job; you or your dependents increase or decrease work hours, or switch from part-time to full-time; you or your dependent begin or return from an unpaid leave of absence that results in acquiring or losing eligibility for health insurance
• Change of your worksite - or that of your spouse or domestic partner, resulting in a change of benefits offered
• Change due to a relocation - of your residence to outside the plan's service area
• Qualified medical child support order - the plan receives a court order requiring you to provide coverage for a dependent child. 
• Change in qualification for Medicaid or S-CHIP - you, your spouse or dependent gain or lose qualification for the State Children's Health Insurance Program 9S-CHIP) or Medicaid (Refer to Special Enrollment Rights in the Benefits Handbook for more information).  

When Changes Can Be Made

Changes must be made within 31 days of the qualifying event (60 days if qualified under the Medicaid and State Child Health Insurance Program (S-CHIP))

What You Need to Do

You must complete a new Graduate Student Employee Health Plan Enrollment Form. The "Change in Enrollment" box must be marked and the type of change being made must be indicated. The form must be submitted to your campus Benefits Office.

When Changes Become Effective

There is no waiting period for coverage when changes are made, and the coverage becomes effective the date of the qualifying event.