Common use of Changes Outside of Open Enrollment Clause in Contracts

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of application. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of application. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of application. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMED) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMED. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-part- time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planthird-party administrator.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.through

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to Employer shall add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.through

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to Employer shall add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planthird-party administrator.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-part- time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planplan third-party administrators.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to Employer shall add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may must change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.longer

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes Coverage changes from single to family and family to single may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationapplication the event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationapplication the event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-part- time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationapplication the event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMECSOD) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMECSOD. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to Employer shall add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation.be 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planthird-party administrator.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planthird-party administrator.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s current health plan.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of application. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of application. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of application. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s employee‟s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMED) pertaining to an employee’s employee‟s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMED. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans if the employee either no longer resides or no longer works in the service area of the employee’s employee‟s current health plan.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. i.e., enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section Section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections Sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planthird-party administrator.

Changes Outside of Open Enrollment. In order to maintain premium payment with pre-tax earnings, any changes outside of open enrollment must be in compliance with the applicable rules of the Internal Revenue Code Section 125 which may include but not be limited to the following: Changes from single to family and family to single following (see the DAS website for additional information): Coverage changes may occur if requested within thirty-one (31) days of any of the following events: 1. After marriage, death of a spouse, divorce, legal separation, or annulment, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 2. Birth, adoption, placement for adoption, or death of a dependent, in which case coverage becomes effective with the birth, adoption, or placement of a child or date of death. 3. Termination or commencement of employment by the employee, spouse or dependent, in which case coverage becomes effective the first day of the month following the month of applicationthe event. 4. Reduction or increase in hours of employment by the employee (including layoff or reinstatement from layoff), spouse, or dependent, including a switch between part-time and full-time, strike, lockout, or commencement, return to work from an unpaid absence, or change in work site in which case coverage becomes effective the first day of the month following the month of applicationthe event. 5. Return to work through order of arbitration or settlement of a grievance, or any administrative body with authority to order the return to work of an employee. 6. The employee’s dependent satisfies or fails to satisfy the requirement of the definition of dependent due to attainment of age, student status or any similar circumstance as provided in the Health Plan under which the employee receives coverage. 7. If the plan receives a Qualified Medical Child Support Order (QMEDQMCSO) pertaining to an employee’s dependent, the employee may elect to add or drop the child to the plan depending upon the requirement of the QMEDQMCSO. 8. If an employee, spouse, or dependent who is enrolled in a health plan becomes entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). 9. If an employee, spouse, or dependent is no longer entitled to coverage (i.e. enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines). Requests for changes pursuant to sections (1) through (9) must be supported by proper documentation. 10. An employee may change health plans third-party administrators if the employee either no longer resides or no longer works in the service area of the employee’s current health planthird-party administrator.