Jump to content

Enrollment after marriage consistency


Recommended Posts

Posted

Employee waived enrollment rights for company medical insurance. So, if SHE later gets married, how does this marriage allow her to enroll herself in the company health plan under the IRS consistency provisions?

(there was an old, pre-2000 posting that said that marriage would be a QE to allow her to enroll, regardless of her initial waiving of the benefit)

:confused:

(I will also add )

What if Employee HAD insurance then got married and spouse has more money than Bill Gates so Employee decides he/she doesn't want to bother with insurance anymore. Can Employee revoke election WITHOUT another plan to go to?

Posted

If an employee gets married, this triggers a HIPAA special enrollment. Under HIPAA, the new dependents and the employee can be added to the medical coverage (any health plan subject to HIPAA), even if the employee had originally opted-out, and 125 allows a change in this case under 1.125-4(B). Keep in mind that a 125 plan does not have to allow this change. HIPAA requires that the underlying plan be made available to the employee and spouse/dependents, but the payroll deductions for such coverage may have to be taken post-tax if the 125 plan does not allow a change in this case.

As for your other example, the 125 consistency rules prevent this. The only way for the employee to drop coverage following marriage is when that other coverage actually becomes effective [1.125-4©(3)(iii)].

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use