We’ve all been there. You’re sitting through an open enrollment meeting at work or skimming through your benefits packet. You’re expected to make major decisions, but you’re left with more questions than answers. What do all these terms mean? How do they impact me? How do they impact my family?
Let us help you better understand all the terms you’re seeing during open enrollment so you can make the best choices for you and your family.
Open Enrollment
Open enrollment is the period of time when you may enroll yourself and/or dependents, disenroll yourself and/or dependents, or change your benefit elections. After the enrollment deadline, you may not change your benefit elections until the next open enrollment period unless you have a qualifying event.
Qualifying Event
Qualifying events include:
- Marriage, divorce, or legal separation (state specific)
- You add a dependent child through birth, adoption, or court-ordered custody
- Death of a spouse or child
- Your work schedule changes, affecting benefits, i.e. reduction or increase in hours, affecting eligibility
- Your dependent loses eligibility for coverage
- Your spouse involuntarily loses health coverage through his/ her employer
- You take an FMLA leave of absence
- You and/or your spouse and dependents become eligible for COBRA
- You and/or your spouse or dependents gain or lose Medicaid coverage
- You receive a Qualified Medical Child Support Order (QMCSO)
- You and/or your spouse or dependent loses coverage under State Children’s Health Insurance Program (SCHIP) under Title XXI of the Social Security Act
- You and/or your spouse or dependent becomes eligible for group health plan premium assistance under Medicaid or SCHIP plan