Common use of When Coverage May Be Changed or Cancelled Clause in Contracts

When Coverage May Be Changed or Cancelled. a. Changes Due to a Life Event. After the initial enrollment period and outside of any open enrollment period an employee may elect to change health or dental coverage (including adding or canceling coverage) and any applicable employee contributions in the following situations (as long as allowed under the applicable provisions, regulations, and rules of the federal and state law in effect at the beginning of the plan year). 1. A change in legal marital status, including marriage, death of a spouse, divorce, legal separation and annulment. 2. A change in number of dependents, including birth, death, adoption, and placement for adoption. 3. A change in employment status of the employee, or the employee’s or retiree’s spouse or dependent, including termination or commencement of employment, a strike or lockout, a commencement of or return from an unpaid leave of absence, a change in worksite, and a change in working conditions (including changing between part-time and full-time or hourly and salary) of the employee, the employee’s or retiree’s spouse or dependent which results in a change in the benefits they receive under a cafeteria plan or a health or dental plan. 4. A dependent ceasing to satisfy eligibility requirements for coverage due to attainment of age, student status, marital status, or other similar circumstances. 5. A change in the place of residence of the employee, retiree or their spouse or dependent. 6. Significant cost or coverage changes (including coverage curtailment and the addition of a benefit package). 7. Family Medical Leave Act (FMLA) leave. 8. Judgments, decrees or orders. 9. A change in coverage of a spouse or dependent under another employer’s plan. 10. Open enrollment under the plan of another employer. 11. Health Insurance Portability and Accountability Act (HIPAA) special enrollment rights for new dependents and in the case of loss of other insurance coverage. 12. A COBRA-qualifying event. 13. Loss of coverage under the group health plan of a governmental or educational institution