Alert

Changes Outside of Annual Enrollment

Applies to

Benefit eligible employees who wish to make a change to their benefit elections outside of annual enrollment.

Answer

The Internal Revenue Service (IRS) provides guidelines on when employees can and cannot make changes to their pre-tax benefit programs. The categories listed below reflect the “Qualifying Life Events” that are required by the IRS for a change to be allowed and most are addressed separately in other guides.

  • You change your legal marital status, which includes marriage, death of spouse, divorce, legal separation, or annulment.
  • Your dependents change due to birth, adoption, placement for adoption, or death of the dependent.
  • You, your spouse, or your dependents terminate or commence employment.
  • You, your spouse, or your dependents reduce or increase their hours of employment.
  • Your dependents cease or commence to satisfy the requirements for coverage due to attainment of age or student status.
  • You, your spouse, or your dependents change place of residence or work.
  • You, your spouse, or your dependents are entitled to coverage under Part A or Part B of Medicare, or Medicaid.
  • You, your spouse or your dependents commence or return from an unpaid leave of absence such as Family and Medical Leave or military leave.
  • You receive a court order to provide coverage for your child (ren).
  • There is a substantial change (at least $50 per month) in the premiums and/or benefits in the plan covering dependents. Example: Spouse covers dependent child (ren) and the cost of spouse’s coverage increases at least $50 per month, dependents can be added to your plan.
  • You stop the withholding of premiums from your pay.

If none of the events listed apply to an employee’s situation, the employee will need to wait for the next annual enrollment period in order to enroll or make changes to their benefits. There are some exceptions as listed below, or you may contact the Employee Benefits Office to discuss your situation with an analyst.

Change Instructions

If the change increases your insurance premiums, catch-up deductions may apply. All forms may be found online.

Changes to the Health Insurance

Employees who are not currently enrolled in the State Health Plan may enroll at any time for any reason by submitting the State Health Plan Enrollment Application Online. Enrollment will be effective the first of the month following completion of the form, and will be considered a Late Enrollment – waiting periods and pre-existing condition exclusions will apply.

Employees may cancel Health Insurance coverage at any time for any reason by submitting the Online State Health Plan Change form. This will cancel Health Insurance benefits for the employee and all covered dependents, and the employee will be unable to re-enroll until the next Annual Enrollment period or in response to a Qualifying Life Event. Cancellation will be effective the first of the month following completion of the form.

Employees may remove all covered dependents from their Health Insurance coverage by submitting the Online State Health Plan Change form. Dependents removed in this fashion will be unable to re-enroll until the next Annual Enrollment period or in response to a Qualifying Life Event. The change is effective the first of the month following completion of the form.

Note: The ONLY time an employee may switch from one plan to another (e.g. Basic Plan to Standard Plan) is within 30 days of hire or during the Annual Enrollment period.

Once completed, employees should keep a copy for their records and forward all originals to:

UNC Health Care Employee Benefits

211 Friday Center Drive, Suite 2057

Chapel Hill, NC, 27517

Changes to NCFlex Benefit Elections (Vision, Dental, etc)

Employees who do not have a valid Qualifying Life Event as defined by the IRS are unable to enroll, change, or cancel their NCFlex benefit elections until the NCFlex Annual Enrollment period.

Other Benefits

To make changes to a benefit not discussed on this page, please contact the benefits vendor directly by visiting the Contact Information page on the Employee Benefit Website.

Example

Ben had wanted to add his child to his NCFlex Dental Insurance but forgot to make the change during the NCFlex Annual Enrollment. He would like to make the change now, but none of the Qualifying Events listed apply as neither his nor his child’s eligibility has changed. He will need to wait for the next NCFlex Annual Enrollment period to make the change.

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