Change in Family Status (CIFS)

[Guest kp]

Wife covers husband under health plan under a cafeteria arrangement. Husband is hired by same employer. Son comes into the US as an alien. Husband desires to stay on wife's plan and add son. (Husband could always elect his own coverage, drop out of his wife's coverage, and husband could pick up the son -- if no issue with son's alien status) May wife pick up son under CIFS rules? Issues: (1) under pre/post 11/97 cafeteria regulations? (2) is the husband's new hire status sufficiently related to adding on the son for coverage?

[Lisa Hand]

Is the son recently adopted? If not please define "son comes into the US as an alien".

[KIP KRAUS]

If the son is the legal son of either employee and is otherwise eligible for medical coverage as any other similarily situated dependent child would be, I would allow the son to be enrolled. To me, living outside the U.S. and then moving to the U.S. would qualify as a CIFS. Unless there is some question as to the legal status as a dependent of the employee(s) I wouldn't think being an alien should not preclude medical coverage for the son while residing in the states.

[Guest kp]

The son is not recently adopted. Can anyone cite some regulatory or other authority to analogize that the son coming into the country is a CIFS?

[Lisa Hand]

The husband's hire, or rather his eligiblity for benefits upon hire is a change of status event regulatory authorization - 1.125-2 QA-6©(1989) as well as 1.125-4T(1997).

As far as the son goes, if he is a dependent then the change of status rules in regard to change in residence or worksite of employee, spouse or dependent would apply.

You should also check your plan documents to see how specifically change of status is defined and if your plan permits this change.

[Guest dbob]

Help! Is there a definitive resource out there (i.e. website) that I can access which can tell me what does and does not constitute an approved family status change? A colleague and I are differing on the following scenario:

Our employee has family med coverage (pre-tax plan). Her spouse is unemployed and is currently covered on her plan. Said spouse lands job and is offered coverage. I say that our employee cannot cancel her pre-tax plans to join her husband's plan. I say that she can drop her husband and kids (if any) but must wait until the next open enrollment to drop herself. Am I on track?

Thanks.

[Lisa Hand]

Treas. Reg 1.125-4T (3)(1) & (2)(B) found at 62 Fed. Reg. 60165 (Nov. 7, 1997) addresses this issue.