HIPAA Special Enrollment Rights
Under the Health Insurance Portability and Accountability Act (“HIPAA”), you have special enrollment rights under certain circumstances.
If you are declining enrollment for yourself, your spouse or other dependents because of other medical insurance or group health plan coverage, you may be able to enroll yourself and your dependents in a Company-sponsored medical plan if you or your dependents lose eligibility for that other coverage (or if the other employer stops contributing toward your or your dependents’ other group health coverage). Effective April 1, 2009, “other coverage” includes other group health plan insurance, Medicaid coverage, or a State’s Children’s Health Insurance Program (CHIP). Additionally, you and/or your dependent(s) may be able to enroll in a Company-sponsored medical plan if you and/or your dependent(s) became eligible for state premium assistance under Medicaid or CHIP. However, you must request enrollment within 30 days after other coverage ends (or after the employer stops contributing toward the other coverage). Note however, you must request enrollment within 60 days of an event that involves loss of Medicaid or CHIP coverage or eligibility for state premium assistance.
In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself, your spouse and your new dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
If you request a change due to a special enrollment event within the applicable timeframe, coverage will be effective the date of birth, adoption or placement for adoption. For all other events, coverage will be effective the first of the month following your request for enrollment.
Qualified change in status
You may also enroll yourself, your spouse and/or your eligible dependents for coverage mid-year in certain circumstances.