• Qualifying Special Enrollment Event


    What is a special enrollment event?

    An event as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that may provide a special enrollment period for individuals and dependents when there is a loss of other coverage or a gain of additional dependents. Such events include:

    • Marriage
    • Divorce (resulting in a loss of coverage)
    • Birth
    • Adoption or placement for adoption
    • Involuntary loss of coverage
    • Change of employment status
    • Medicaid/CHIP/Medicare

    Can coverage be dropped for an employee or dependent throughout the plan year?

    Not unless there has been a qualifying special enrollment event. If it has been determined that there has been a qualifying life event, an employee cannot drop coverage for himself without also dropping coverage for all of his dependents. The change will be effective the first day of the following month. If coverage is dropped, for a given individual, that individual will not be eligible to re-enroll in TRS-ActiveCare until the next annual enrollment period unless the individual experiences a special enrollment event.


    What do I do if I have a qualifying special enrollment event?

    Contact the Benefits Office at 817-232-0880, ext. 2978 or by email at jmcnutt-erwin@ems-isd.net if you have any questions about your qualifying special enrollment event.Changes in coverages may be made by submitting the appropiate documentation:
    • Letter from spouse's employer
    • Certificate of Marriage
    • Verification of birth facts
    • Birth Certificate
    • Completed hospital certificate that includes foot prints
    • Divorce Decree
    • Certificate of Death
    • Medicare Enrollment
    • Medicaid/Chips Enrollment
    • Loss of Medicaid or Chips