For all of us, life is a continuing process of change—marriage, birth, adoption, a new job, divorce and death. Should one of these events occur in your life, you may need to rethink, and more than likely, make changes to your enrollment in certain Emory benefit programs, such as: Medical, Dental, or Flexible Spending Accounts.
Family Status Change
When a life-changing event occurs, you can make a mid-year change to your current benefit elections without waiting for the annual election period (typically in the fall of each year for the following calendar year).
Enrollment changes can only be made within 31 days of the qualifying event and must be consistent with the change in status. After the 31-day timeframe, you are only able to change your elections during the annual open enrollment period.
In most cases, the effective date of the change is the "qualified" family status change is the actual "event date". However, in some situations (divorce, legal separation, change to employment), the effective date of the change is the first of the month following the actual "event date".
Add a Dependent
The IRS permits a change to your annual election within 31 days of the following qualified family status events:
Unmarried from age 18 to 25 provided
they are full-time students who have been
actively enrolled and attending school for five
consecutive months in the year between each
birthday AND are receiving over half of their
financial support from you.
Birth, Adoption, Placement for Adoption
Marriage, Same-Sex Domestic Partner (SSDP)
Legal Guardianship, Foster Child
The IRS considers the following actions "consistent" with Adding a Dependent under Family Status Change rules if done within 31 days:
Medical &
Dental
Health Care
FSA
Dependent Care FSA
Life Insurance
Enroll spouse/ domestic partner
Add any eligible/ affected dependents
Increase/start contributions
Decrease/drop contributions
For guardianship and foster child: no decrease/drop contributions are permitted.
No changes allowed for domestic partner.
Increase/start contributions
Decrease/stop contributions
For guardianship and foster child: no decrease/drop contributions are permitted.
Enroll spouse/ SSDP/child
Drop coverage
PAI changes can be made anytime.
Steps to Take:
Provide documentation to the Benefits Department.
For a domestic partner, provide a Statement of Same-Sex Domestic Partnership, as well as proof of committed relationship such as mortgage statement, utility bills or credit cards with both names on them etc.
For a legal guardianship or foster child, provide the judgment, decree or court order.
Change in Employment - Gain of Benefit Plans Eligibility
The IRS permits a change to your annual election within 31 days of the following qualified family status event:
Change to Benefits eligible status: regular full-time or part-time at least 20 hours or temporary full-time
designated as "greater than a six-month assignment"
The IRS considers the following actions "consistent" with Gaining Benefit Plans Eligibility under Family Status Change rules if done within 31 days:
Medical &
Dental
Health Care
FSA
Dependent Care
FSA
Life Insurance
Enroll employee
Add spouse/SSDP
Add dependent(s)
Start contributions
Start contributions
Enroll in coverage
Add spouse/SSDP/child
Add PAI
Steps to Take:
Provide documentation to the Benefits Department
For a domestic partner, provide a Statement of Same-Sex Domestic Partnership, as well as proof of committed relationship such as mortgage statement, utility bills or credit cards with both names on them etc.
Change in Employment - Employee Terminates and is Rehired
The IRS permits a change to your annual election within 31 days of the following qualified family status event:
An employee who is rehired.
The IRS considers the following actions "consistent" with Rehiring an Employee who had Terminated under Family Status Change rules if done within 31 days:
Medical &
Dental
Health Care
FSA
Dependent Care
FSA
Life Insurance
Rehired within 31 days:
reinstate prior elections. No changes allowed.
Rehired within 31 days:
reinstate prior elections. No changes allowed.
Rehired within 31 days:
reinstate prior elections. No changes allowed.
Rehired within 31 days:
reinstate prior elections. No changes allowed.
PAI changes can be made anytime.
Rehired after 31 days:
treat like a newly hired/ newly eligible employee or reinstate prior election if within calendar year
Rehired after 31 days:
treat like a newly hired/ newly eligible employee or reinstate prior election if within calendar year
Rehired after 31 days:
treat like a newly hired/ newly eligible employee or reinstate prior election if within calendar year
Rehired after 31 days:
treat like a newly hired/ newly eligible employee or reinstate prior election if within calendar year
PAI changes can be made anytime.
Employee or Dependent Entitlement to Medicare or Medicaid Coverage
The IRS permits a change to your annual election within 31 days of the following qualified family status event:
An employee or dependent being eligible for Medicare or Medicaid Coverage
The IRS considers the following actions "consistent" with Employees Entitled to Medicare or Medicaid Coverage under Family Status Change rules if done within 31 days:
The IRS permits a change to your annual election within 31 days of the following qualified family status event:
Court orders include QMCSO, requiring employee to provide health coverage for dependent
The IRS considers the following actions "consistent" with Judgments, Decrees, and Court Orders under Family Status Change rules if done within 31 days:
Medical & Dental
Health Care
FSA
Dependent Care
FSA
Life Insurance
Enroll employee
Add newly eligible dependent only
Increase/start contributions
No changes allowed
No changes allowed
PAI changes can be made anytime.
Steps to Take:
Provide documentation to the Benefits Department
For a legal guardianship or foster child, provide the judgment, decree or court order.
Hours of Operation:
Monday through Friday from 8:00 a.m. to 5:00 p.m.
1599 Clifton Road, NE
Atlanta, GA 30322
(404) 727-7613
Disclaimer
Emory reserves the right to terminate, suspend, withdraw, amend or modify the Plan in whole or in part at any time. Further, Emory reserves the right to terminate or modify coverage for any group of employees, active or retired and their dependents or a class of dependents at any time.
