Tag: Section 125

Question: If an employee is adding a new baby to his healthcare plan, can this employee also add his spouse at the same time? Answer: Yes. Under the Health Insurance Portability and Accountability Act (HIPAA), group health plans are required to offer mid-year special enrollment for the spouse and/or new baby (and the employee if not…

Question: Our employee waived health coverage for himself and family under our plan and has been covered on his spouse’s employer plan.  The spouse recently lost her job and lost health care coverage.  Would this qualify as a mid-year election change under our plan to allow the employee and his entire family to come on…

Question: We have an employee out on a non-FMLA leave who elected not to continue benefits because she is out of the country for her extended personal leave.  How will the carrier view the HIPAA preexisting conditions rules upon reinstatement to benefits from the leave and would that be a COBRA qualifying event? Answer: Under…

Question: Do the Section 125 mid-year election change rules allow for the addition of “tag along” dependents when a child is added mid-year due to a Qualified Medical Child Support Order? Answer: Under the IRS rules (http://www.irs.gov/pub/irs-regs/td8921.pdf), if the plan so allows for mid-year changes (not all plans do) and has “tag along” rules included…