Change of Status & Allowable Mid-Year Enrollment Changes
Below is a brief summary of some of the more common change of status events and the mid-year enrollment changes employees can make to their health plan (medical, dental and/or vision).
Change of status or eligibility changes permitted in accordance with Section 125 of the Internal Revenue Code1.
This chart is only a summary of some of the permitted health plan changes and is not all inclusive.
- Rules above apply equally to IRS qualified and non-qualified dependents for consistency and ease of administration.
- Have 60 days from loss or eligibility determination of Medicare, Medicaid, Medi-Cal or SCHIP to request special enrollment.
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The above benefit election changes are effective as follows:
- Canceling Coverage: Effective date of change is generally the last day of the month after the event that allowed the change.
E.g., Spouse obtains other group coverage on the 1st of the month. Coverage for spouse ends on the last day of the prior month.
- Adding new/changing coverage: Effective date of change is generally the first of the month following or coinciding with the event that allowed the change.
E.g., Married on the 1st of the month. Coverage for new spouse is effective on the 1st of the same month.
Married on the 2nd of the month. Coverage for new spouse is effective on the 1st of the following month.
- New Hires: Effective on the 1st of the month following date of hire.
E.g., Hired June 1, 2010. Coverage is effective on July 1, 2010.
Hired June 9, 2010. Coverage is effective July 1, 2010.
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Effective Date Exceptions
- Birth/Adoption: Effective on the 1st of the month following date of birth/adoption. Medical plans will cover a newborn under the subscriber’s coverage from date of birth through the end of the birth month. Submit paperwork to your payroll clerk or Human Resources early and no later than 31 days from the date of birth to ensure medical coverage for the child.
- Return from Military Leave: Effective on the date you return to work.
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Room 116 B
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Long Term Disability
Long Term Disability Benefit Program
County of Sonoma currently provides two (2) separate insured Long Term Disability Benefit (LTD) plans.