My Employee Would Like to Change Her Health Insurance Coverage Post-Election--i.e. Mid-Year. Is this Possible?

Maybe.  For plans that are created pursuant to Section 125, otherwise known as cafeteria plans, there are a number of situations that could arise that could allow your plan to permit an employee to revoke her previous election and make a new election. These issues can be very complicated factually and legally, but the following are some of the examples of situations that cafeteria plans may allow participants to change their benefits after their election:

  • Change in legal marital status

  • Change in the number of dependents

  • Change in the participant’s employment status -- examples include...

    • start or end of employment

    • change in worksite

    • strike or a lockout

    • commencement or return from an unpaid leave of absence

  • Dependent satisfies or ceases to satisfy the eligibility requirements for the plan

  • Change in residence

  • Adoption assistance


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