Allow Employees To Purchase Voluntary Benefits

Even with no employer contribution, theres value in offering voluntary or worksite benefits like accident or critical illness insurance. Why? Because its a lot less expensive than health insurance and can help to offset high medical bills. This means that an employee who cant afford to cover his family members on his health plan can still reduce their exposure with these relatively inexpensive products.

What Exactly Is A Qualifying Life Event

A qualifying life event is a big life-changing situation sometimes planned, sometimes unexpected that can impact you and your health insurance. Experiencing a significant life change may allow you to change your health plan outside of the annual enrollment period .

Qualifying life events include :1

• Having or adopting a baby

• Getting married

• Moving to a new area

• Experiencing a shift in employment status

• Turning 26

• Death of someone who shares your health plan

• Earning U.S. citizenship

• Turning 65

Having A Baby: Javier Adopts A Little Girl

Javier, 38, and his husband live in Miami, Florida. They just adopted a three-month-old girl, Lucía, and want to give their daughter the best of everything. Right now, Javiers high-deductible health plan only covers him and his spouse. But he can easily change that. When you welcome a child to your family through birth or adoption, thats considered a qualifying life event. After he brings Lucía home, Javier contacts his health plan to inform them of the event and chooses a lower deductible plan suitable for his entire family.

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If There Has Been A Change In Dependents

You must take specific steps if the number of dependents increases due to marriage or childbirth or a family member is no longer eligible as a dependent for reasons such as employment, living apart from the insured person, or death.Eligibility will be cancelled retroactively if you fsubmit a factually inaccurate notification or do not submit the notification required. If so, you will be required to repay all medical care expenses and benefits provided during that time.The Health Insurance Society checks the eligibility status of dependents annually.

Health Coverage For International Students

Full-Time Students

• The cost of the health insurance policy is included in full-time tuition fees.
• Health insurance coverage will be provided through Guard.Me and will commence on the first day of the month of the scheduled program date, provided that tuition fees have been paid.
• Health insurance documents will be emailed to students Sheridan email accounts per timeline below:
• Fall Term Start- end of September
• Winter Term Start- end of January
• Spring/Summer Term Start – end of May NOTE: please make sure to check all folders in your email, including junk email.
• If a student needs to visit the doctor for urgent care , they are advised to contact the International Centre to request an expedited policy.
• All policies expire on August 31. No exceptions will be made.
• Health insurance fee will not be refunded once a policy has been issued.

Part-Time Students

• International students who drop to part-time status will still be charged the full health insurance fee.
• International students in the Faculty of Continuing Education and Professional Studies do not qualify for the health insurance plan. It is the responsibility of each student to ensure that they purchase adequate health insurance coverage while staying in Canada.

Coverage upon Arrival

• Students arriving to Canada earlier than the scheduled start date are responsible for arranging their own medical coverage.

Review your Health Insurance Coverage

Mobile Doctor by Guard.Me

Mental Health Coverage by Guard.Me

Exemptions

NOTES:

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Requirements For Adding Your Children As Dependents

If you have children, theyre probably the first people that come to mind when talking about dependents. Generally speaking, you can include any child who fits the following criteria:

• Age: Your child has to be under the age of 26.
• Relationship to You: For a child to qualify as your dependent, he or she needs to be your biological child, your stepchild, your adopted child, or a foster child you are taking care of. If your child has other sisters, brothers, half sisters, half brothers, or children of their own, you can also include them on your health insurance plan.
• Length of Residency: A child only qualifies as your dependent if they have lived with you for at least six months.
• Income Contribution: Although your child can be your tax dependent while working and contributing to their own expenses, they cannot be their own primary source of support. This means a childs income must be less than half of the cost of their support expenses to qualify as your dependent.
• Tax Filing: A child cannot be your dependent if they file a joint tax return that year.
• Other Claims: A child cannot be claimed as a dependent by more than one household. So, regardless of your relationship, if someone else claims your child as a dependent, you cannot.

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Remove Spouse Or Child

If you are removing a spouse, you will be required to upload one of the following:

• A divorce decree
• A notarized statement or affidavit signed by you and/or your spouse or
• A statement dated and signed by you and/or your spouse, including
• The date of your divorce or separation
• Full names for you and your former spouse
• Your former spouses current address, or an indication that the new address is unknown and
• Account Numbers or PHNs for you and your spouse

If a family has applied for and been deemed eligible for MSP supplementary benefits, a spouse establishing coverage on their own account will maintain eligibility for the current year, after which they must re-apply for supplementary benefits on their own account.

If you are removing a child, you do not need to upload supporting documentation. However, the child must have coverage under another account. A child 19 years of age or over will be set up on their own account.

Request MSP Account Change

Once the form has been submitted, a reference number will be displayed. Please allow 21 days for account change requests to be reviewed and processed. If your request is successful and no additional information is required, your account will be updated. You will receive a letter from Health Insurance BC if additional information is required.

For more information about adding a spouse or child to your account, or to submit your request using alternate methods, please review the information below.

Educate Employees About Chip

The Childrens Health Insurance Program offers quality coverage to low-income families at a very affordable price. The cutoff level, costs, and benefits vary by state, but heres a quick example of how it works. In Texas, families with incomes below 200% of the federal poverty level, or $50,058 per year, can qualify for CHIP. For those who qualify, they can cover all of their children for just $50 per year or less. Spending a couple of minutes explaining the Childrens Health Insurance Program during an enrollment meeting and handing out a free brochure is a great way to help employees at no cost and with almost no effort. Why wouldnt an employer want to do that?

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Key Takeaways About Qualifying Life Events

The bottom line is, you might not need to wait for your employer or the government’s next open enrollment period to make changes to your health plan. Here’s what else you should know:

• To make changes to your health plan, you must be experiencing a qualifying life event. If youre not sure an event qualifies, visit Healthcare.gov or contact your current or future health plan sponsors for more specific information.
• Qualifying life events trigger a “special enrollment period” that typically lasts 30 to 60 days, depending on your plan, during which you can select a new plan or add a new dependent to your plan.
• To change your plan selections, notify your current or future health plan sponsor of the qualifying event in your life as soon as possible.
• Other qualifying life events include getting married, losing coverage due to divorce, losing eligibility for Medicaid, and exhausting your COBRA coverage.
• Different plans have different rules. Contact your plan administrator about any change in status that impacts your health coverage to find out your rights.

Who Do I Notify When A Dependent Loses Eligibility For Coverage

You have the responsibility to inform your employer of any dependents losing eligibility for coverage under the State of Wisconsin Group Health Insurance Program. Under federal law, if notification is not made within 60 days of the later of the event that caused the loss of coverage, or the end of the period of coverage, the right to continuation coverage is lost. A voluntary change in coverage from a family plan to a individual plan does not create a continuation opportunity.

If your last dependent is losing eligibility, you must file an application to change to single coverage.

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Qualifying Events That Trigger Special Enrollment

Outside of open enrollment, you can still enroll in a new plan if you have a qualifying event that triggers your own special open enrollment window.

The Supreme Court just upheld the ACA. Should marketplace insurance buyers breathe a sigh of relief?

People with employer-sponsored health insurance are used to both open enrollment windows and qualifying events. In the employer group market, plans have annual open enrollment times when members can make changes to their plans and eligible employees can enroll. Outside of that time frame, however, a qualifying event is required in order to enroll or change coverage.

In the individual market, this was never part of the equation prior to 2014 people could apply for coverage anytime they wanted. But policies were not guaranteed issue, so pre-existing conditions meant that some people couldnt get coverage or had to pay more for their policies.

All of that changed thanks to the ACA. Individual coverage is now quite similar to group coverage. As a result, the individual market now utilizes annual open enrollment windows and allows for special enrollment windows triggered by qualifying events.

Health Care Coverage Forms

Other Options:

• Use this version if you’d prefer to print, fill out and submit the form yourself

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Adding Your Spouse As A Dependent

In most cases, adding a spouse to your health insurance plan is acceptable. After getting married, you usually have up to 60 days to enroll in a new plan, or add your spouse as a dependent.

Keep in mind that if you or your spouse have access to employer-sponsored health insurance, but choose to buy your own family plan on a health insurance exchange, you likely will not qualify for Obamacare subsidies. Check out eHealths other resources to learn more about how health insurance works with marriage. If you have questions, you can also talk to one of eHealths licensed insurance agents to discuss coverage options that might fit your familys needs.

Who Doesnt Need A Qualifying Event

In some circumstances, enrollment is available year-round, without a need for a qualifying event:

• Native Americans/Alaska Natives as defined by the Indian Health Care Improvement Act can enroll anytime during the year. Enrollment by the 15th of the month will result in an effective date of the first of the following month. Native Americans/Alaska Natives may also switch from one QHP to another up to once per month .

• Medicaid and CHIP enrollment are also year-round. For people who are near the threshold where Medicaid eligibility ends and exchange subsidy eligibility begins, there may be some churning during the year, when slight income fluctuations result in a change in eligibility.

  If income increases above the Medicaid eligibility threshold, theres a special open enrollment window triggered by loss of other coverage. Unfortunately, in states that have not expanded Medicaid, the transition between Medicaid and QHPs in the exchange is nowhere near as seamless as lawmakers intended it to be.

• Employers can select SHOP plans year-round. But employees on those plans will have the same sort of annual open enrollment windows that applies to any employer group plans.

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Individual Plan Renewing Outside Of The Regular Open Enrollment

HHS issued a regulation in late May 2014 that included a provision to allow a special open enrollment for people whose health plan is renewing but not terminating outside of regular open enrollment. Although ACA-compliant plans run on a calendar-year schedule, that is not always the case for grandmothered and grandfathered plans, nor is it always the case for employer-sponsored plans.

Insureds with these plans may accept the renewal but are not obligated to do so. Instead, they can select a new ACA-compliant plan during the 60 days prior to the renewal date and 60 days following the renewal date. Initially, this special enrollment period was intended to be used only in 2014, but in February 2015 HHS issued a final regulation that confirms this special enrollment period would be on-going. So it continues to apply to people who have grandfathered or grandmothered plans that renew outside of open enrollment each year. And HHS also confirmed that this SEP applies to people who have a non-calendar year group plan thats renewing they can keep that plan or switch to an individual market plan using an SEP.

How And When To Add Your Parents To Your Healthcare Plan

Get your parents under your health insurance policyor find them the best low-cost coverage for their situationwith these tips.

Navigating the U.S. healthcare system can feel like being stuck in a labyrinth, especially when you have what seems to be a simple question: Can I add my parents to my healthcare plan? If you’re wondering whether you can extend your coverage to one or both of your parents and how, you probably won’t be surprised to learn the answers, respectively, are it depends and it’s complicated.

“The biggest obstacle when it comes to adding parents to your healthcare plan is the research required to determine if your situation allows for coverage,” says , a board-certified, independent patient advocate. “As a general reminder, there is no mandate requiring health plans to offer parents coverage. So finding out will require a lot of proactive digging on your part.”

Here’s how to do the excavation of your situation or policy.

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Pay For Ancillary Benefits

For some reason, employers get it in their minds that they have to be consistent in the way they pay for the various benefits they offer. However, the truth is that they can leave the dependent health insurance costs up to the employees and pay for lower-cost benefits like dental or life insurance. Dental insurance is about one-tenth of the cost of health insurance and people value it almost as much, so its a great benefit for a company to pay for . And group life insurance is cheap, so employers can provide a base level of benefits for the employee, spouse, and children and then allow them to buy up if they want.

When Can I Change From Family To Individual Coverage Or Individual To Family Coverage

If your employee premiums are deducted on a pre-tax basis under Internal Revenue Code Section 125 rules, switching from family to individual coverage is not allowable unless there is an IRS qualified family status change such as divorce, marriage, birth or adoption. For example, all covered family members lose eligibility for health coverage or become eligible for and enroll in another group plan. If any covered dependents remain eligible for coverage, a change from family to individual coverage is allowed only during the annual open enrollment period.

If your employee premiums are deducted on a post-tax basis or you are a retiree, you may change from family to individual coverage at anytime. The change will be effective on the first day of the month on or following receipt of your electronic or paper application by your benefits/payroll/personnel office . Switching from family to individual coverage when you still have eligible dependents is deemed a voluntary cancellation of coverage for all covered dependents and is not considered a “qualifying event” for continuation coverage.

State only: If you have individual coverage and you should die, your sick leave credits will not be available for use by your surviving dependents.

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