Changing Your Coverage

If your health benefit premium contributions are being deducted from your pay on a pre-tax basis, then you may only change your coverage level, coverage option (e.g. Traditional PPO to Deductible PPO) and pre-tax deduction during open enrollment, unless you have a special enrollment right or other qualifying event.

If your health insurance deductions are being taken on an after tax basis, you may change your coverage level anytime during the year, but coverage of new individuals is subject to a five pay-period wait unless you have a qualifying event. Refer to Changing Your Coverage in the Health Care section of the Benefits Handbook.

If you add dependents without a qualifying event, the employee portion of the premium will remain pre-tax and the dependent portion will be an after tax deduction until the next plan year.

To make changes, you must complete a new RF Benefits Enrollment Form and submit through the "Make a Change" service ticket within 60 days of the event.  If the newly completed enrollment form is received within 60 days of the event, the change is effective retroactively to the date of the event. 

Qualifying Events

A qualifying event is a change in an employee's or dependent's status that permits a change to be made in the pre-tax health insurance elections outside of the annual enrollment period.  The change in status must result in a gain or loss of coverage or coverage options.  The change in health insurance election must be consistent with the change in status. For details refer to the Health Care section of the Benefits Handbook or Postdoctoral Benefits Handbook. These rules are governed by the federal tax code. 

Special Enrollment Rights

Apart from qualifying events, special enrollment rights allow you to make changes to your medical coverage (but not Dental Care, Vision Care, or Health Care Flexible Spending Accounts), outside of your initial enrollment period or the annual open enrollment period in three specific circumstances: (1.) you gain a dependent, (2.) you or a dependent loses coverage under another plan, and (3.) you or a dependent becomes eligible for assistance through a State Children's Health Insurance Plan.  These specific circumstances are based on rules enacted by the Health Insurance Portability and Accountability Act (HIPAA).

For additional information on special enrollment rules, refer to the Benefits Handbook or Postdoctoral Benefits Handbook.