Mid-Year Changes

change

The enrollment options you elect during open enrollment will remain in effect for the entire plan year. You must wait until the next open enrollment period to make changes UNLESS you experience an IRC Section 125 change-in-status event as noted in the Section 125 Change-in-Status Event Matrix, such as:

  • A legal marital status change including marriage, death of spouse, divorce or annulment
  • Commencement or dissolution of registered domestic partnership
  • A change in the number of dependents, including birth, death, adoption or placement for adoption
  • A change in employment status for you, your spouse, your domestic partner or your dependent, such as termination or commencement of employment, a strike or lockout, or commencement of or return from an unpaid leave of absence
  • Your dependent satisfies or ceases to satisfy eligibility requirements due to age or any similar circumstance
  • A residence change affecting eligibility for you, your spouse, your domestic partner or your dependent
  • You or your dependent becomes entitled to Medicare or Medicaid (eligibility or loss of eligibility)
  • Significant changes in group benefit plan costs or coverage terms including the addition or elimination of a benefit plan
  • Commencement of or return from a leave of absence
  • Judgment, decree or order resulting from a divorce, annulment or change in legal custody (including a qualified medical child support order as defined in Section 609 of the Employee Retirement Income Security Act of 1974) that requires medical or dental coverage for an employee's child or for a foster child who is a dependent of the employee

Requesting a Mid-Year Change

Your request to make a mid-year change must:

  1. Be consistent with the qualifying event
  2. Meet the guidelines of County contracts/agreements, plan documents and IRC Section 125
  3. Be received by the Employee Benefits and Services Division (EBSD) within 60 days of the qualifying event

Effective Date of Mid-Year Changes

All elections made during the plan year shall become effective the first day of the pay period following the date that the properly completed Premium Deduction Election Form and documentation are received by the EBSD within the applicable election period, with the exception of HIPAA special enrollments.

Elections shall only apply to compensation that has not yet been earned at the time of the election unless otherwise allowed under Internal Revenue Code Section 125, federal regulations, the County’s Section 125 Premium Conversion Plan and the terms of the group benefit plans. You will be billed for any premiums owed as a result of the addition of eligible dependents. To reduce the time for a refund or to reduce the amount of premiums owed, you are encouraged to submit your paperwork as soon as possible. If the change-in-status event results in a decrease in premiums, you will receive a refund on a subsequent pay warrant for the premium overpayment.

If you have questions about mid-year changes, contact the EBSD at 909.387.5787 or send an email.


Newborn Children

Please note, for Blue Shield, newborn children will be covered under the medical group the mother (parent) is assigned to, for the first 30 days. For Kaiser members, newborns are covered for the first 31 days, including the date of birth. Employee subscribers must still enroll the newborn under their respective plan through the County or else the newborn will not be covered beyond the initial aforementioned time frames. Submit your mid-year change paperwork within 60 days of birth, even if you are waiting to receive the official birth certificate.

Contact the EBSD or your payroll specialist to complete the newborn enrollment.


Section 125 Premium Conversion Plan

This plan allows employees to pay for eligible benefits using either before-tax or after-tax dollars. If no changes are made to the eligible benefits during open enrollment, the previous plan year’s elections will continue automatically. For new employees, if no election is made, the deductions will automatically be taken after tax and the employee will be subject to all plan requirements and restrictions. View the Section 125 Premium Conversion Plan page for further information.

County of San Bernardino © 2015. All rights reserved. | Privacy Policy | E-mail Webmaster | Disclaimer | Accessibility

157 West Fifth Street, First Floor • San Bernardino, CA 92415-0440 • Phone 909.387.5787 • TTY Users 711 • Fax 909.387.5566