REMINDER: Need to Add a Dependent to Your Benefits Coverage? You May Have 30-60 Days to Do it

TO:         Fresno Unified School District Employees/Retirees

DATE:     May 17, 2020

Generally, dependents are only eligible to be added to your benefits coverage once a year – during the annual Open Enrollment period. However, there are certain situations (known as “qualifying life events”) that allow you to add dependents and/or spouses to your benefits coverage outside of the annual Open Enrollment period.

Depending on the life event, you have either 30 or 60 days to request enrollment through the District, otherwise you’ll have to wait until the annual Open Enrollment period. Here’s an overview of the different qualifying life events and their respective notification requirements:

Must Request within 30 Days of the Qualifying Life Event

  • Loss of Coverage: If your dependents lose eligibility for other coverage due to separation/divorce, termination of employment or reduction in hours, death or cessation of employer contributions.
  • New Dependent: If you have a new dependent as a result of marriage, entering into a domestic partnership, birth, adoption or placement for adoption. Spouses or Domestic Partners may also be eligible to be enrolled as a result of this event.

Must Request within 60 Days of the Qualifying Life Event

  • SCHIP Eligibility: If your dependents experience a loss of eligibility for Medicaid or a State Children’s Health Insurance Program (“SCHIP”) coverage; or if your dependents become eligible for a state premium assistance subsidy through Medicaid or a SCHIP program with respect to coverage under this Plan.

As long as the notification requirements are met, coverage will generally start relative to the date of the qualifying life event; however, certain circumstances may apply, so please always be sure to check the Plan booklet for specific details.

If you have a qualifying life event, the best first step is to contact the Benefits Department. They will assist you in gathering the appropriate documentation to complete the special enrollment. For more information or questions regarding enrolling dependents/spouses due to a qualifying life event, please contact the Benefits Department at (559) 457-3520.

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