You should always elect benefits during open enrollment to ensure you get the coverage you need; however, once enrolled in health coverage like a cafeteria or Section 125 plan, you are unable to change your elections until the plan year ends. Sometimes qualifying life events occur, which allow you to change your election outside of the standard enrollment period.
How do I know if I can change my election?
- 1. You must experience a midyear election change event recognized by the IRS (see list below).
- 2. Your cafeteria plan must permit midyear election changes for that event.
- 3. Your requested change must be consistent with the midyear election change event.
What does the IRS consider to be a qualifying event?
- a. Change in status (legal name, marital status, number of dependents and others).
- b. Significant plan cost changes
- c. Significant curtailment of coverage
- d. Change in coverage under another employer’s plan
- e. Addition or significant improvement of benefits package option
- f. FMLA leaves of absence
- g. Loss of group health coverage sponsored by a governmental or educational institution
- h. COBRA qualifying events
- i. HIPAA special enrollment events
- j. Medicare or Medicaid entitlement
It’s important to note that not all events qualify for all plans and all benefits. You should consult your plan document for clarification, and as always call us if you need any help.
