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ELIGIBILITY
Who is Eligible to Join the Employee Benefit Plan?
You and your dependents are eligible to join the health and welfare benefit plans if you are a full-time employee regularly scheduled to work 30 hours per week or more You must be enrolled in the plan to add dependent coverage
Who is an Eligible Dependent?
• Your legal spouse
• Your dependent child under the maximum age specified in the carriers’ plan documents including:
Natural child
Adopted child
Stepchild
Child for whom you have been appointed as the legal guardian
*Your child’s spouse and a child for whom you are not the legal guardian of are not eligible.
The dependent maximum age limit is up to age 26. The dependent does not need to be a full-time student; does not need to be an eligible dependent on the parent’s tax return; is not required to live with you; and may be unmarried or married
Once the dependent reaches age 26, coverage will terminate. Some policies may terminate on the last day of the birth month Other policies may terminate on the birthday
A totally disabled child who is physically or mentally disabled prior to age 26 may remain on the medical policy if the child is primarily dependent on the enrolled member for support and maintenance
When Do Benefits Become Effective?
Your employee benefits become effective on the first day of the month following 30 days of full-time employment with Commdex Consulting.
Annual Open Enrollment?
Each year during the annual Open Enrollment Period, you are given the opportunity to make changes to your current benefit elections To find out when the annual Open Enrollment Period occurs, contact Human Resources.
Qualifying Event Changes
You are allowed to make certain changes to your current benefit elections during the plan year if you experience an IRS-approved qualifying event The change to your benefit elections must be consistent with and on account of the change in life status
IRS-approved qualifying life status changes include:
• Marriage, divorce or legal separation
• Birth or adoption of a child or placement of a child for adoption
• Death of a dependent
• Change in employment status, including loss or gain of employment, for your spouse or a dependent
• Change in work schedule, including switching between full-time and part-time status, by you, your spouse or a dependent
• Change in residence or work site for you, your spouse or a dependent that results in a change of eligibility
• If you or your dependents lose eligibility for Medicaid or the Children’s Health Insurance Program (CHIP) coverage
• If you or your dependents become eligible for a state’s premium assistance subsidy under Medicaid or CHIP
If you have a qualifying even, you must notify the company and make your desired changes within 31 days of the event. You have 60 days to make changes due to a Medicare or CHIP event.
If you do not notify the company during that time, you and/or your dependents must wait until the next annual open enrollment period to make a change in your benefit elections.
Please note, loss of coverage due to nonpayment or voluntary termination of other coverage outside a spouse’s or parent’s open enrollment is not an IRSapproved qualifying life event, and you do not qualify for a special enrollment period