Open Enrollment Period & Qualifying Events: What’s the Difference?

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As a group administrator, you are probably all too familiar with that time of year when employees sign up for benefits – also known as the open enrollment period. But did you know there are instances where employees and their family members can enroll outside of this period? This special enrollment period takes place when an employee experiences a qualifying event. Basically, when an employee undergoes certain life events, they are automatically eligible for health benefits. So what are the other differences between open enrollment and qualifying events? It’s always good to review, so let’s break them down.

 

QUALIFYING EVENTS

Specific qualifying events will grant your employees a special eligibility period. During this time, they can sign up for or change existing benefits outside of the usual open enrollment cycle. The 30-day period begins on the date of the qualifying event and requires all changes to be submitted to and authorized by the employer.

Qualifying events include any of the following:

– Marriage, divorce or legal separation

– Birth or adoption of a child

– Death of insured

– Loss of other coverage or gaining coverage

– Loss of employment or new employment

 

OPEN ENROLLMENT PERIOD

Open Enrollment Period is the only time during the year that employees can enroll or change benefits without a qualifying event. Open enrollment occurs on a yearly basis, generally the same time of year, and will have a specified deadline that your company chooses. During this time, your employees can enroll on insurance plans, or make changes to their current plan. As a reminder, any elections or changes need to be submitted by the last day of open enrollment. From there, these submissions will be in place by your company’s next effective date.

Still have a question about when your employees can enroll? Feel free to contact a Dental Select representative at 800-999-9789 and we’d be happy to help.

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