In general, the Internal Revenue Service prohibits you from changing any coverage elections, or enrolling in or canceling any coverage, under the Flexible Benefits Program outside of Open Enrollment. However, the rules of the Internal Revenue Service, the Board of Community Health and the Employee Benefit Plan Council do permit you to change coverage or enroll or cancel coverage in certain limited circumstances if the change corresponds to a qualifying change in status event.
The Employee Benefit Plan Council and the Board of Community Health have the responsibility to interpret these rules and make the final decision as to whether you may enroll or change any coverage outside of the Open Enrollment period. Your request for enrollment or a change outside of the enrollment period will only be considered if you submit the proper documentation within the time frame allotted.
To submit a request for enrollment or changes to coverage under the State Health Benefit Plan, you must submit a completed Membership or Discontinuation Form to your employer's Benefits Coordinator within 30 days of a qualifying event (unless another time period is specified). Your request for enrollment or a change in any other coverage under the Flexible Benefits Program must be submitted in writing to your employer's Benefits Coordinator within 30 days of a qualifying event (unless another time period is specified).
Submission of a request for enrollment or a change, or the occurrence of a qualifying event, does not guarantee that you will be able to enroll or change coverage outside the enrollment period. Please see your Benefits Coordinator if you have questions about when you may enroll or make changes outside the enrollment period.
For a list of possible change in status events that might permit you to enroll or change one or more coverages under the Flexible Benefits Program. Please refer to the Terms and Conditions in the front of the You Decide! booklet.
Any changes will go into effect the first of the month following the date when the payroll is changed to reflect your new choice. However, within the State Health Benefit Plan, when you change coverage based on the acquisition of dependents, the coverage effective date for the new coverage may be retroactive to the date of the acquisition of the dependent in some circumstances, or may be the first of the month following the request to change coverage.
If you have questions regarding a change in any of your coverages, first call your employer's Benefits Coordinator. If you need further information about eligibility for health coverage, call the State Health Benefit Plan at 404-656-6322 or 1-800-610-1863. For questions regarding other coverages, call the Flexible Benefits Program at 404-656-2730 or 1-888-968-0490.
NOTE: If you decline State Health Benefit Plan (SHBP) coverage because you have coverage elsewhere, you may be able to enroll in one of the SHBP benefit options if you lose that other coverage because eligibility for the other coverage ends, or extended COBRA coverage is terminated. Call the State Health Benefit Plan at 404-656-6322 for more information and mandated timeframes.
