Change of status

[Guest mbmorgan]

Is a change in status from union to non-union a qualifying event, if both employee groups are covered by the same cafeteria plan with the same eligiblity requirements? The non-union group has one additional health plan option, but employee would not lose the plan in which currently enrolled as a union employee. The employee contribution is not signficantly different.

[jsb]

One could argue that, if there are other different health plan options available, a change could be permitted, if permitted under the plan documents, provided the change is consistent with the event.

You indicate that there is an additional plan available to non-union employees. If that plan is materially different than the union offerings, eg. it's a PPO and only HMOs are offered to the union, you could probably justify allowing a change into that plan based on "change in cost or coverage". Allowing enrollment in the PPO would be consistent with the event because a different type of plan is offered to the non-union employees.

On the other hand, allowing the employee to switch into another plan type that is already offered to both union and non-union employees, might not be allowed as it would not be consistent. Similarly, if the "different" plan being offered to non-union employees is basically just a different carrier offering the same type of plan with the same covered services at the same cost, it might be more difficult to justify allowing a change.