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Brought to you by Insurance Center of New England, Inc.

What is a Qualifying Event?
May, 2011 - Vol I
Need More Information?

To learn more about qualifying events or if you have  questions regarding any of our previous Beyond Benefits topics, please contact Judy Davis at

(413) 750-7133.  

 

For previous editions of our Beyond Benefits newsletters just go to our website, from the link provided icnegroup.com.

 

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What Constitutes a Qualifying Event?

A qualifying event is one that would cause an employee who had group health coverage to lose that coverage or has a family status change, such as the birth of a child.  Dropping coverage during open enrollment is not a qualifying event.  Examples of qualifying events are as follows:

Qualifying Events for Employees
  • Voluntary or involuntary termination of employment for reasons other than gross mparents & babyisconduct.
  • Reduction in the number of hours of employment below plan eligibility requirements.
  • Marriage, divorce or the birth/adoption of a child of a covered employee.
Qualifying Events for Spouses
  • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct.
  • Reduction in the hours worked by the covered employee below plan eligibility requirements.
  • Covered employee's becoming entitled to Medicare.
  • Divorce or legal separation of the covered employee.
  • Death of the covered employee.
Qualifying Events for Dependent Children
  • Loss of dependent child status under the plan rules. Kids running
  • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct.
  • Reduction in the hours worked by the covered employee below plan eligibility requirements.
  • Covered employee's becoming entitled to Medicare.
  • Divorce or legal separation of the covered employee.
  • Death of the covered employee.
Qualifying Events and Flexible Spending Accounts or Health Savings Accounts

For specific questions with regards to Flexible Spending Accounts and Health Savings Accounts; please consult with your benefits specialists; however, below are guidelines for FSA's and HSA's when administering a qualifying event:

Employees may only make pre-tax contributions to their H.S.A. when they are enrolled in an H.S.A. qualified High Deductible Health Plan. Once an employee is no longer in said health plan, they are no longer eligible to make pre-tax contributions.

A spouse of an employee actively enrolled in an H.S.A. may NOT participate in an F.S.A.  The reason being is that the spouse, whether they are on the employee's plan or not, is eligible to receive reimbursement from the H.S.A. If they were to also enroll in the F.S.A, this is considered 'double dipping'.

Once an employee is no longer enrolled in an H.S.A. qualified High Deductible Health Plan, they will still have access to the funds remaining (not including the employer contribution).  Also, they are now eligible to enroll in any other reimbursement plan, including their spouse.   

Insurance Center of New England's Beyond Benefits is providing this reference as general information only.  It is not intended to be legal advice.
ICNE LogoInsurance Center of New England, Inc. is a regional independent insurance agency providing full-service commercial and personal insurance protection and group employee benefits programs.  Based in Agawam, MA as Insurance Center of New England, Inc. and in Gardner, MA as Heritage Insurance Agency, we have satellite locations in Chelmsford, Danvers, Fitchburg, Lowell, Orange and Winchendon.

For additional information contact Judy Davis at (413) 750-7133 or jdavis@icnegroup.com.