Change in Status
Pre-tax health and welfare benefits cannot be changed outside of an open enrollment period except in the case of a qualifying change in status. Certain changes in family status or tax status or changes in an individual’s, spouse’s, or domestic partner’s employment that change eligibility for benefits may meet the definition of a change in status. Any desired benefit change must be consistent with the event and the change must be completed with Human Resources within 30 days of the event. For example, if the birth of a child is the change in status, a consistent change would be to add your child to your medical coverage no later than 30 days after the date of birth.
The one exception to the 30-day rule is for qualifying changes relating to CHIP and Medicaid. Only these qualifying changes allow for a 60-day window to make changes in your Rice benefits. This special enrollment opportunity is triggered if the employee or dependent who is otherwise eligible, but not enrolled in, a group health plan:
- loses eligibility for coverage under a State Medicaid or CHIP program, or
- becomes eligible for State premium assistance under a Medicaid or CHIP program.
The following are examples of qualifying changes in status:
- legal marriage or divorce
- death of a spouse, partner or dependent child
- birth or adoption of a child
- spouse’s termination of employment or a new job
- change of employment status from full-time to part-time or vice versa (with a change in benefits eligibility)
- taking an unpaid leave of absence
- open enrollment of a spouse’s plan
Also, in some circumstances, the law allows you to change plans upon a qualifying change in status (for example, change from CDHP to HMO upon birth of a child, or change from the HMO to the ACO upon retirement). These are known as HIPAA special enrollment events.
We will require “proof” of your qualifying change in status. For the birth of a child, this might bea birth certificate or the “Birth Facts” from the hospital if you have not received a copy of the Birth Certificate. When a spouse gets new health insurance, this might include a copy of his enrollment form (including the effective date of the new coverage).
The documentation of the event must have the name of the affected individual, the date of the event, and, if applicable, the name of the new or old insurance plan option you wish to change.
Please plan for the timing of your change in status. Most changes can only be made the first of the following month. Make all changes on the Benefits Portal. Call 713-348-2363 for assistance.