NJ_BenAdmin

Hi. An employee just notified us that he forgot to include a dependent child on his dental coverage when electing the plan during open enrollment in November 2019 (the child was selected to be covered under the medical and vision plans). We are wondering if there would be any administrative type reason to allow the child to be covered, retroactive to 1/1/2020 or if doing so would violate Section 125/ERISA rules? There has been no qualified life event or status change to permit a mid-year enrollment. This is purely an issue where the employee just realized their mistake 7 months into the plan year. Thanks!

Hi, I just need to confirmation on this event: we have an employee who is married and was covered by his parent's employer. His coverage ended on 6/30/19. He wanted to use his special enrollment period to enroll not only himself, but also his spouse (who has no qualifying loss of coverage). I told the employee he could not enroll his spouse, at this time, but am getting some push back and just wanted to make sure I am not mistaken. Thanks!

Yes, the plan permits enrolling dependents. The employee reached out to me in mid-May to inquire as to why the children were not enrolled. This is when I told him we were unaware of any Court Order. I did just put through the enrollment for the children, retro back to 4/1/19. While not a QMCSO, the Court Order had all other relevant information, including the employee's name/signature, the children's names and DOB's, the date they should be covered, and which plans to enroll them in. I took this as being qualified based off the information from the booklet david rigby provided.

We have an employee who is being required by the court to cover his 2 dependent children on our health plan. The employee reached out to inquire why the update was not done. I told him we have yet to receive the QMCSO from the state. The employee provided the signed Consent Order from the court that details the requirement to add the 2 children. He and his attorney think that the Civil Action Order produced by the court for the child support agency did not include a provision to add the children, just the removal of his child support payment; which could be why a QMCSO was never sent. The coverage effective date was 4/1/19 according to the Consent Order and the employee lives in NJ. Thoughts on next steps? Ok to use the Consent Order or should I tell the employee he needs to get a QMCSO generated and sent? I read through the H&W SPD and it doesn't appear that the Consent Order would qualify, but just wanted to get guidance elsewhere.