For When Life Changes
Life brings about many changes that can affect coverage. These life events may occur outside the Annual Open Enrollment period. In this case, an employee may need to apply for or adjust their coverage.
Pre-tax benefits are generally irrevocable for the plan year under Section 125 of the Internal Revenue Code (IRC). However, the Section 125 regulations provide specific instances when an employee can make midyear election changes (or "permitted change in election events"):
- Change in marital status.
- Change in number of dependents.
- Change in employment.
- Change in dependent eligibility due to plan requirements (e.g., loss of student status, age limit reached).
- Change in residence (e.g., employee or dependent moves out of plan service area).
- Significant cost changes in coverage.
- Significant curtailment of coverage.
- Addition or improvement to benefits package option.
- Change in coverage of spouse or dependent under another employer plan (e.g., spouse's employer had no insurance coverage before but now offers a plan).
- Loss of certain other health coverage (e.g., plans provided by governmental or educational institutions).
- Health Insurance Portability and Accountability Act (HIPAA) special enrollment rights.
- Judgments, decrees or orders.
- Entitlement to Medicare or Medicaid.
- Change in hours worked to less than 30 hours per week on average if the employee and covered family members enroll in another plan providing minimum essential coverage.
- Enrollment in a marketplace exchange plan during an exchange special or open enrollment period. Employees and others covered must enroll in the exchange plan by the first day after coverage ends under the employer plan. See IRS Notice 2014-55 for details.
The employee generally has 30 days from the date of the qualifying event to apply for or adjust coverage. The requested coverage change must relate to the qualifying event.
Some changes to Healthcare FSAs may not be permitted. Check with your employer regarding the plan design and/or restrictions.
To apply for or adjust coverage, let your account manager know or contact us.
Account Management Changes
Mailing address or banking information for direct deposit can be updated online at anytime. Simply login and select My Profile from the home dashboard. Employees can also fill out the appropriate form(s) and mail it to American Fidelity. Click the buttons below to download and print a form.