Change in Status

[Guest TuckerB]

Employee A has elected coverage for herself and her husband, B. Employee A then has a baby, C. A's husband has health insurance through his employer. A seeks to drop her coverage and enroll in her B's health insurance. Can employee A drop her current coverage or does she have to continue to maintain coverage for herself with C and B going on to B's insurance. Thanks!

[Guest mrsntc]

Employee A has elected coverage for herself and her husband, B. Employee A then has a baby, C. A's husband has health insurance through his employer. A seeks to drop her coverage and enroll in her B's health insurance. Can employee A drop her current coverage or does she have to continue to maintain coverage for herself with C and B going on to B's insurance. Thanks!

It is my understanding that A would be allowed to drop her coverage at the child's birth based on the fact that it is a qualifying event.

[Guest TuckerB]

Employee A has elected coverage for herself and her husband, B. Employee A then has a baby, C. A's husband has health insurance through his employer. A seeks to drop her coverage and enroll in her B's health insurance. Can employee A drop her current coverage or does she have to continue to maintain coverage for herself with C and B going on to B's insurance. Thanks!

It is my understanding that A would be allowed to drop her coverage at the child's birth based on the fact that it is a qualifying event.

Even if A's coverage consists of both A and B at the time of the birth of C? I just am not sure if this is in line with the consistency rule. Thanks

[leevena]

An employee can drop their coverage ( I am assuming you mean health insurance ) anytime they would like. Even if their employer offers free health insurance, they can still decline to enroll. Or, are you asking about a 125 plan and it's requirements?

Am I missing something in this question? Your last line asks "Can employee A drop her current coverage or does she have to continue to maintain coverage for herself with C and B going on to B's insurance. Thanks!

[GBurns]

Declining to enroll is different than dropping coverage. To be able to drop coverage the employee must first have been enrolled.

The problem then is stopping an election for premium during the plan year.

The OP does not state whether there is either a cafeteria plan or an employee share of premium. I think that more info is needed.

It also seems that B had dual coverage.

But there is also the question of whether B can change his coverage at this time.

The OP does not state whether the coverages (both employer plans) have a dependent tier or a Family tier etc. If the birth of C allows a change to Family then A would be covered along with C by default.

[Guest TuckerB]

An employee can drop their coverage ( I am assuming you mean health insurance ) anytime they would like. Even if their employer offers free health insurance, they can still decline to enroll. Or, are you asking about a 125 plan and it's requirements?

Am I missing something in this question? Your last line asks "Can employee A drop her current coverage or does she have to continue to maintain coverage for herself with C and B going on to B's insurance. Thanks!

I will try to make my question more clear. A has health insurance through her ER. A has chosen the HDHP family coverage for herself and her husband. A has a baby, C. A seeks to drop her HDHP coverage and move to B's health insurance. B has health insurance through his ER. Can A drop her current coverage due to the fact that she has had a baby? Thanks!

[masteff]

Or, are you asking about a 125 plan and it's requirements?

As the OP's 2nd post cites the consistency rules, I guess I'm getting confused... does anything other than Section 125 have a consistency rule when discussing health plan enrollment changes?

TuckerB, perhaps you can also specify if your question relates specifically to the Section 125 change of status rules. (Some people are overly literal and other assume the moon and everything else is included.)

[Guest TuckerB]

Or, are you asking about a 125 plan and it's requirements?

As the OP's 2nd post cites the consistency rules, I guess I'm getting confused... does anything other than Section 125 have a consistency rule when discussing health plan enrollment changes?

TuckerB, perhaps you can also specify if your question relates specifically to the Section 125 change of status rules. (Some people are overly literal and other assume the moon and everything else is included.)

Yes, the question relates to the Section 125 change of status rules. Many thanks!

[masteff]

What if you approach it from the angle of a change in coverage under the spouse's plan? Then consistency wouldn't seem to apply. The spouse (B) should be able to elect family coverage due to the new dependent and the employee (A) should be able to drop current coverage due to that new coverage. ???

[GBurns]

Somehow I see no change of status.

Employee A has Family coverage which would include the new child C. Nothing changes as far as I see except to list the name of the additional family member. Coverage is unchanged.

Since the coverage is unchanged I see nothing that would allow employee A to drop coverage.

But maybe approaching it like masteff suggests might work.

[Guest TuckerB]

What if you approach it from the angle of a change in coverage under the spouse's plan? Then consistency wouldn't seem to apply. The spouse (B) should be able to elect family coverage due to the new dependent and the employee (A) should be able to drop current coverage due to that new coverage. ???

I agree. Thanks!