• 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 on 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 appropriate documentation below:
    • Letter from spouse's employer
    • Certificate of Marriage
    • Verification of birth facts
    • Birth Certificate
    • Completed hospital certificate that includes footprints
    • Divorce Decree
    • Certificate of Death
    • Medicare Enrollment
    • Medicaid/Chips Enrollment
    • Loss of Medicaid or Chips

    Documentation of the qualifying life event as well as an Enrollment Change Form must be submitted within 30 days of the qualifying life event to Jamie Erwin either by fax (817)-232-0238 or by email jmcnutt-erwin@ems-isd.net

    If documentation and the change forms are not submitted within the 30 days of the QLE the employee will have to wait to make changes to their benefits during the next open enrollment event.

    Click here for Enrollment Change form