Life Events
If you have a life change, such as getting married or having a baby, you should make sure your benefit coverage continues to match your needs. In most cases, you cannot change your benefit elections until the next annual Open Enrollment period. If the event occurs during the year, special rules apply to changing coverage.
There are generally two categories of life event changes:
Changes in your / your spouses employment status of benefits
Such as:
- Gain/loss of full time status affecting level of benefit coverage
- Spouse gaining/losing employment
Such as:
- Marriage
- Divorce
- Birth/Adoption
- Death
You may change your elections during the year if you experience one of the following qualified life event changes:
Legal Marital Status – Events that change your legal marital status, including marriage, death, divorce, legal separation (according to state law) or annulment
Number of Dependents – Events that change the number of your eligible dependents, including birth, adoption, foster care, placement for adoption or death of a dependent
Employment Status – Events that change your employment status, or the employment status of your spouse/domestic partner or dependent, including termination of employment; a change in worksite; or any other employment status change that results in a gain or loss of eligibility under the relevant employer plan (for example, a switch from non-benefited to benefited). If your status changes from non-benefited to benefited or vice versa, your benefit costs will change
Dependent Eligibility – An event that causes the gain or loss of a dependent's eligibility for benefits
Residence – A change in where you, your spouse/domestic partner or dependent lives
Any election change you make must satisfy the "consistency rule", and you may be asked to provide supporting documentation for all life event changes.
The consistency rule means that you can only change benefits that are directly linked to the qualified change you experience. For example, if you have or adopt a child you can add a new dependent to your coverage. However, you cannot change your medical plan election when you have or adopt a child since the life event does not have a direct impact on your coverage choice.
The following table lists some common life event changes and the types of benefit adjustments you may request in each situation.
LIFE EVENT | BENEFIT | ALLOWABLE CHANGES |
---|---|---|
Marriage or Domestic Partnership* | Medical Dental Vision Spouse Life / Child Life Child Life Supplemental Life Health Care FSA Dependent Care FSA |
Add or discontinue coverage for yourself, your spouse/domestic partner and/or new or existing dependents Elect coverage Increase or decrease coverage by one level for yourself Increase your contributions Elect, increase, decrease or discontinue your contributions |
Loss of Spouse or Domestic Partner (divorce, separation, annulment, loss of domestic partner status, death) |
Medical
|
Must discontinue coverage for your former spouse/domestic partner Elect coverage for yourself or dependents who lose coverage under your former spouse's/domestic partner's plan Increase or decrease coverage for yourself Discontinue spouse coverage Elect, increase, decrease or discontinue your contributions |
Add a New Dependent (birth, adoption, placement for adoption, foster care, legal guardianship) |
Medical
Spouse Life / Child Life
|
Elect coverage for yourself and new or existing dependents
|
Loss of Dependent (change in eligibility or death) |
Medical
|
Must discontinue coverage for the dependent who loses eligibility Discontinue Spouse or Child Life for the dependent that loses coverage Decrease or discontinue your contributions |
Employee/Dependent Gains Eligibility for Other Coverage |
Medical
|
Discontinue coverage for dependent or discontinue all coverage Elect, increase, decrease or discontinue your contributions Discontinue coverage |
Employee/Dependent Loses Eligibility for Other Coverage |
Medical
|
Add dependents or elect coverage
|
OTHER EVENTS | ALLOWABLE CHANGES |
---|---|
Certain Court Orders | You may elect medical coverage for your child if a qualified medical child support order (QMCSO) requires coverage under Barnes' plan. You may cancel coverage for your child if your spouse, former spouse or other individual provides coverage for the child because he or she is required to do so due to a judgment, decree or order resulting from a divorce, legal separation, annulment or change in legal custody. |
Changes Made Under Another Employer's Plan | You may change your election in response to a change made in your spouse's/domestic partner's employer's plan during that plan's enrollment period. This rule applies only if the other employer's plan has a different plan year. |
Significant Change in Medical Provider Network | If there is a substantial decrease in the number of physicians participating in a provider network, or if your health plan option is eliminated, you may switch to another health plan option or drop coverage if no other viable option is available. Barnes will determine whether the number of physicians participating in an option has decreased substantially. |
Changes in Entitlement for Medicare or Medicaid | If you, your spouse/domestic partner or dependent becomes entitled to coverage under Medicare or Medicaid (other than solely under the program for distribution of pediatric vaccines), you may elect to cancel coverage for the entitled person. Note: If you become entitled to Medicare or Medicaid and currently have a spouse/domestic partner or dependent(s) covered under the Barnes Group plan, you may not cancel coverage for yourself only. If you cancel your coverage, coverage for your spouse/domestic partner and dependent(s) will end as well. |
Loss of Medicare, Medicaid or Group Health Coverage Sponsored by an Educational or Government Institution | If you, your spouse/domestic partner or your eligible dependent loses eligibility for Medicare or Medicaid or loses group health coverage sponsored by an educational or government institution, you may add coverage for this person(s). This includes a state children's health insurance program (CHIP), a medical program of an Indian Tribal government or the Indian Health Service, a state benefits risk pool or a foreign government group health plan. |
* Expenses for your domestic partner and your domestic partner's children are not eligible for reimbursement through either of the FSAs.
If you have a Qualified Event or Family Status Change and want to make benefit changes during the year:
- You must make any benefit changes within 30 days of the qualified event.
- Most life event changes can be made online using the Marketlink Enrollment System within 30 days following the date of the event. There are a few life event changes (for example, divorce) which will require the help of your HR Manager.
- You may be required to provide proof of eligibility for any qualified life event to substantiate your changes. This may include marriage license, death certificate, birth certificate or other documentation.