Valid Status Changes

[Guest Eric81975]

When Processing a valid status change, are we limited to 31 days? Our current practice is to process the paperwork as if the event date

assuming we receive the paperwork within 31 days of the event.

Howeve, if we receive the paperwork after 31 days, we process the

status change as of the dates we are notified. Is it acceptable to

accept these status changes after 31 days, or must we tell the

employee to wait until open enrollment?

If someone would be able to assist me on this? Or point me into the right direction I would certainly appreciate it!

Thank you.

[Lisa Hand]

What do your plan documents say?

[Guest Eric81975]

We handle about 30 different medical plans, some of which are self insured.

Is there more freedom, with status changes in regards to a self-insured medical plan as opposed to a regular medical plan?

I also have noticed that most plans are usually in the same range of 30 days, but I also noticed some to be up to 60 days?

[Mary C]

125 regs only state the change must be requested in a "reasonable" time. Also, the HIPAA regualtions have a special enrollment period of 30 days after birth, adoption, etc. So it is reasonable to use the 30 days for all changes since HIPAA mandates that period for certain enrollment.

As usual, the regulations only state the minimum - plans could be more liberal as long as they do it consistently and in a non-discriminatory manner.