Spouse Incarcerated - Status Change?

[Guest EHSchaab]

A plan participant maintains employee plus spouse medical coverage. The spouse recently was incarcerated and is now in the "big house", maintaining access to health coverage while visiting. The employee wishes to reduce medical coverage from employee plus spouse to employee only. If gaining access to government sponsored health coverage is not considered a qualifying event, wouldn't the coverage that is gained when entering the pen also be an ineligible event??

[Guest EHSchaab]

Would that be considered a change in residence?

[oriecat]

I was wondering that too, but when I worked through the issue at Change of Status.com it seems to only apply if the change of residence causes an actual loss of eligibility.

[Guest CoreDocuments.com]

I'm Certified in Flexible Compensation. I believe the most appropriate change of status or qualifying event here would be a "change in Residence". Your plan document should have been updated after the 2002 IRS clarification of "Change of Status" provisions. It added almost 8 pages to our plan document and 4 pages to our SPD.

Gene Ennis, CFC

www.CoreDocuments.com

[GBurns]

If the spouse is being sent to an area where coverage is not available and there is no alternative coverage, it should qualify as a "Permitted Response by Employee to Curtailment resulting in Loss of Coverage".

[SLuskin]

Coverage would certainly not be available. To my knowledge, no furloughs are granted so that the spouse could be seen by any network physician. Therefore, the actual impossibility of receiving benefits would seem to be a change in residence making access to the network impossible.