What Life Changes Affect Benefits Coverage?
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What Life Changes Affect Benefits Coverage?

Every day employees face issues that change their lives. Life events may require changes to your current benefits. Know your benefit options and know what you need to do. If you experience a family status change, the most important step you need to take is to notify SDSU Research Foundation Human Resources office within 31 days of the change. Benefits Representatives will assist you with the appropriate actions you may need to consider. Family status changes are often accompanied by other personal changes as well. A review of your benefits may include adding or dropping eligible dependents from the health and dental plans, changes in name, beneficiaries, address, phone number, direct deposit account information, and W–4 filing status and withholding allowances. Some of the changes in your personal life that require a review of your benefits and some action on your part, might include:

• Marriage
• Registration of a domestic partnership
• Birth or adoption of a child
• Addition of a stepchild or legal ward to your family
• Birth of a child to an eligible and enrolled dependent
• Divorce, legal separation, or annulment
• Dissolution of a domestic partnership
• Child's loss of eligibility for coverage, due the attainment of age 26
• Death of an eligible family member
• Involuntary loss of other group coverage
• Moving out of or returning to a medical or dental plan service area
• Spouse's or domestic partner's gain or loss of employment, where the change affects eligibility for or loss of health and dental coverage
• Court order
• An eligible person ceases to be eligible for Medicaid or SCHIP coverage
• An eligible person becomes newly eligible for a state premium subsidy under Medicaid or SCHIP.

For any plan changes made, coverage for benefits will be effective the first of the month following the date of the event.

Most mid-year special enrollment periods have a 31-day limit for you to report the event to HR. The mid-year special enrollment period for the last two bullet points only allow you up to 60 days to report the loss or gain of coverage to HR.

So which children can be enrolled? Your children up to age 26, even if:

• They don’t live with you
• Are not full time students
• They are married
• They are financially independent
• They have other health coverage through their own employer

If you fail to add a newly eligible dependent to the health or dental plan within the 31 or 60 day special election period, your next opportunity to enroll them in the plans occurs during Open Enrollment, which is typically held each November. Changes made during the annual Open Enrollment period are effective January 1. Don't miss your chance!

It is your responsibility to drop ineligible dependents within the required time frame (31 days of ineligibility). Late notice may jeopardize the dependent's right to continued coverage under COBRA. Additionally, the failure to notify SDSU Research Foundation of the ineligible status of a dependent within the 31 or 60 day window, may subject you to the repayment for any expenses incurred, plus any claims or services received from the plans for ineligible dependents.

Career–related changes and events may also effect your employee benefits. Make arrangements to discuss your options with a representative from SDSU Research Foundation's Human Resources office as soon as you have knowledge of an employment status change. At times, many issues need consideration prior to the effective date of the change. Examples of some of the changes which may affect your employee benefits are:

• Family and medical leave
• Workers' Compensation disability leave
• Disability leave
• Pregnancy disability leave
• Personal leave
• Unpaid leave of any kind
• End of employment

Upon notice of these changes, SDSU Research Foundation's Human Resources Office will provide you with additional information on the options available for continuation of coverage. However, in most situations of unpaid leaves of absence, and end of employment, your employee benefits will end the last day of the month in which the change occurs.