Retiree Special Enrollment Rights

[Guest blabukiff]

An individual who is a member of a health and welfare fund retires. He declines continuing his health insurance benefits and opts instead for Medicare. However, he still keeps his dental, vision, and Rx drug coverage under the Plan.

He subsequently gets married. The member and his new wife want to now enroll in the full plan (or whatever benefits are offered to retirees).

Under the HIPAA special enrollment rules, is the Health and Welfare Plan required to allow the member and his new spouse "back" into the plan as a whole (under retiree benefits)?

Thanks.

[Guest taxesquire]

if he was an active e/e, then he'd have a hipaa event. I don't think the same applies to retiree coverage, but you need to read the plan and what is available to retirees.

If they lose eligibility once they discontinue coverage, then no hipaa event; if they are continuously-eligible (i.e., he'd just have to wait for the next open-enrollment period), then it's more likely that there is a hipaa event.