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Employee Changes

For When Life Changes

Life brings about many changes that can affect your insurance 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 generally can not be changed 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 mid-year election changes (or "permitted change in election events"):

  • Change in marital status.
  • Change in the 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 reduction of coverage.
  • Addition or improvement to benefits package options.
  • Change in spouse or dependent coverage under another employer plan (e.g., spouse's employer had no insurance coverage before but now offers a plan).
  • Loss of certain 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.

It is up to your employer if they wish to allow any or all of the permitted election changes under their Section 125 Plan. Your employer sets the timeframe for when changes related to a qualifying event must be made. Many employers will allow 30 days for you to apply or change your coverage.

Some changes to Healthcare FSAs may not be permitted. Check with your employer regarding the plan design or restrictions.

To apply for or adjust coverage, contact your account manager or your employer.

 

Account Management Changes

Mailing address or banking information for direct deposit can be updated online. Simply login and select 'Update your Information' link under My Profile from the home dashboard. You can also fill out the appropriate form(s) and mail it to American Fidelity. Click the buttons below to download and print a form.

American Fidelity Assurance Company
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