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When should medical coverage start?
Benefits & Compensation
When should medical coverage start?
Exchange ideas about health plans, retirement, work/life benefits, and employee assistance.
Our S125 plan doc states in the Irrevocability of Election section:
A participant entitled to make a new election under Section 4.4 (Irrevocability of Election) must do so within 30 days of the eve
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Forums » Topic Forums » Benefits & Compensation » When should medical coverage start?
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When should medical coverage start?
posted at 10/22/2010 9:38 AM EDT
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Posts: 45
First: 12/30/2005 Last: 9/14/2011 |
Our S125 plan doc states in the Irrevocability of Election section:
A participant entitled to make a new election under Section 4.4 (Irrevocability of Election) must do so within 30 days of the event described above. An employee who was eligible to elect Health Insurance Plan coverage with Salary Reductions, but who declined to do so during the initial election period or any Open Enrollment Period, may do so within 30 days of the occurrence of an event described above, but only if the election under the new Salary Reduction Agreement is made on account of and is consistent with the event. Subject to the provisions of the underlying group health plan, elections made to add medical coverage for a newborn or newly adopted Dependent child pursuant to a HIPAA special enrollment right may be retroactive for up to 30 days. All other new elections shall be effective no sooner than the first day of the payroll period immediately following the date the participant files his or her new salary reduction agreement with the plan administrator. Elections made pursuant to this section shall be effective for the balance of the plan year in which the election is made unless a subsequent event (described above) allows a further election change. Let's say an employee notifies us on October 20th that she wishes to add her spouse who lost other coverage on October 8th. The first day of our next payroll period after October 20th is October 28th. I interpret the above passage as saying that the spouse's coverage with us can start no sooner than October 28th, and that he will be without medical coverage from October 9th through October 27th? That's the way I've always understood it, but I am experiencing a difference of interpretation with our new benefits specialist (she's from Hewitt). She insists that the date of coverage should start the day after the prior coverage ends, even though our plan doc appears to state differently. Opinions? Thanks! |
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When should medical coverage start?
posted at 10/22/2010 10:09 AM EDT
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Posts: 562
First: 11/12/2009 Last: 9/14/2011 |
I think it's pretty clear that the husband is not a newborn and that coverage starts on with the first pay period following election.
If the husband lost coverage, he should have at least COBRA coverage to cover the 2 weeks or so he'd be without. |
Forums » Topic Forums » Benefits & Compensation » When should medical coverage start?
