By Cindy Lohrey, AVP, Payroll & Benefits Manager

Did you know there are times when employees can make changes to their benefit elections outside of the annual open enrollment period? These times are when big changes occur in an employee’s personal life — such as when they get married, have a baby, or lose health coverage. Life events such as these mean an employee may be eligible for a special enrollment period.

Note that this type of change must be reported to Human Resources within 30 days of the event occurring. Here are some basic types of qualifying life events. These are examples and not a full list:

• Loss of other coverage
  • Employee is currently covered under a spouse’s plan, but the spouse loses their job and their benefits cease.
  • Employee is currently covered under a parent’s plan and has now turned age 26. Coverage on a parent’s plan ends at the end of the month in which a dependent turns 26 years old; therefore, the employee could enroll in our benefits.
  • Loss of Medicare, Medicaid, or CHIP (Children’s Health Insurance Program).
• Changes in household
  • Getting married. Congratulations! The employee could now drop coverage here and join the spouse’s plan — time to review your options. If the employee’s new spouse is not covered on another employer medical plan, the spouse could be added to the employee plan here.
  • Getting divorced or going through a legal separation. Once a divorce is finalized (i.e., signed court documents are in hand), the spouse can be removed from the benefit plans. Or, the employee might need to add coverage because the spouse is taking the employee off of their plan.
  • Having a baby or adopting a child. Congratulations! The new child can be added to your benefit plans. Again — be sure to add the new dependent within 30 days of birth or adoption.
• Child support order for medical coverage. If an employee is ordered by the courts to provide medical coverage for children as part of a child support court order, this will come to the bank directly from the courts. The employee will be notified of the change.
• Entitlement to Medicare or Medicaid. If the employee becomes entitled to Medicare or Medicaid, benefit coverage at North Shore Bank can be declined, although the employee is still entitled to remain on our health insurance.

If you experience one or more of the above qualified life events, you have 30 days from the date of the event to notify Human Resources. If you do not notify Human Resources within 30 days of the qualified event, you will have to wait until the next annual open enrollment period to make changes (unless you experience another qualified life event). Documentation of an event may be required; Human Resources will advise if this is required.

Have questions? Reach out to me at clohrey@northshorebank.com or ext. 3384.