employee's self-employed spouse loses coverage due to pre-existing; st

[Guest Carolyn Barnard]

An employee is covered through a cafeteria plan. Her self-employed spouse's coverage through an agent has been cancelled due to the discovery of a condition that has been ruled pre-existing. Can the employee then add the spouse to her coverage? All the guidance I see talks about losing coverage due to a job change or eligibilty change. Again, the spouse is not losing coverage through his employer, as he is self-employed.

[Mary C]

Everything I've read and use for guidance indicate it has to be a loss of other "group" employer coverage in order for it to be considered an event to allow a change to the cafeteria plan election. Was the prior plan considered a "group" plan or was it a personal plan anyone could buy?

[Guest Carolyn Barnard]

It is a personal policy. I have only found guidance on the "group" policies also. I was hoping that someone out there had had this come up before.

[GBurns]

What is a "personal policy"? Is it an individual policy or is it a group policy? Nothing to do with who owns it or who pays for it.

[Guest Carolyn Barnard]

It is an individual policy that he purchased through an insurance agent.