DOL Guidance on Life Changes

Posted by BAS - 22 October, 2020

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The Department of Labor’s publication on life changes provides guidance to employees about protecting health coverage upon certain life events. The publication may be accessed by clicking here

The guidance provides advice for the following situations:

  • When you get married you can change health coverage by
    • Adding yourself, a new spouse or children to an employer’s plan
    • Enrolling in a spouse’s employers plan
    • Finding coverage through the Health Insurance Marketplace.
  • Pregnancy, Childbirth and Adoption
    • Under the Affordable Care Act, most employer plans and all plans purchased through the Health Insurance Marketplace must include coverage for pregnancy, childbirth and newborn care. Most plans also cover well-baby and well-child care without copayment if provided in-network.
    • Birth, adoption and placement for adoption triggers a special enrollment event allowing you to enroll in your employer’s plan or a Marketplace plan.
  • Loss of Dependent Status
    • Children can stay on a parent’s plan until age 26. When a child ages out of the plan, they may be eligible for
      • Coverage under their own employer’s plan
      • Special enrollment in Marketplace coverage
      • Continuation of coverage under COBRA
    • Death, Legal Separation, Divorce
      • When an employee covered under an employer health plan dies, legally separates or divorced, the covered spouse and dependent children may be eligible for
        • Coverage under their own employer’s plan
        • Special enrollment in Marketplace coverage
        • Continuation of coverage under COBRA

Employees with life events should review their options for continuing or changing health coverage.

Topics: HR & Benefits Compliance, Eligibility & Enrollment, HR & Benefit Plans, HR & Benefits News


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