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Changes to Existing Coverage
When employees need to make changes to their existing coverage...
Refer to the table below for a quick overview of the different types of requested changes and when they can be made. To learn more, click on a specific type of change.
|Requested Change||When Change Can Be Made|
Basic Membership Update
(name, address, PCP change)
Note: For small groups who are exempt from open enrollment limitations, changes can be made at any time.
To Request a Change
- Submit a completed Group Enrollment Form - must be signed and dated by employee
- If required, attach "Additional Documentation"
Effective Date of Change
Changes must be received in writing in order for them to become effective. Generally, requested changes become effective the first of the month following BCBSVT's receipt of the group enrollment form and additional documentation, if required.
Events Most Likely to Result in a Change of Membership
The table below outlines the most common events which result in a change of membership. Please note the strict deadlines for submitting the change.
|New Hire/Rehire||No later than 60 days from date of eligibility.||First of the month following date of receipt, but not prior to completion of probationary period.||pg. 13|
|Marriage/Civil Union||Within 31 days following marriage/civil union.||First of the month following marriage/civil union.||
|32 to 60 days following marriage/civil union.||First of the month following receipt.||pg. 22|
|Birth||Within 31 days following birth.||Date of birth for child and 32nd day after the birth for the membership type change.||
|32 to 60 days following birth.||First of the month following receipt.||pg. 23|
|Adoption||Within 31 days following adoption (or placement for adoption).||Date of adoption (or placement for adoption).||
|32 to 60 days following adoption (or placement for adoption).||First of the month after we receive the request.||pg. 24|
|Divorce||Within 60 days of divorce.||First of the month following divorce.||pg. 27|
|Death||Within six months of the date of death.||First of the month following death.||pg. 27|
|Within 31 days after loss of coverage.||Retroactive to date of coverage loss.||pg. 21|
|Voluntary Cancellation||Must sign and submit Group Enrollment Form.||First of the month following receipt.||pg. 29|
|Left Employment||Submit Group Membership Update Form indicating key word as "LE."||First of the month following receipt.||pg. 29|
|COBRA Eligibility||Remove subscriber immediately. If subscriber accepts COBRA within 60 days, he or she can be retroactively reinstated.||Not applicable.||
|Within 90 days of the date of Medicare coverage.||Date of Medicare entitlement. If received prior to Medicare effective date, coverage will be effective to coincide with Medicare.||pg. 33|
employee who refused initial
|Prior to the Anniversary or Open Enrollment month.||Anniversary or Open Enrollment month.||
|During the Anniversary or Open Enrollment month.||First of the month following receipt.||pg. 19|