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Medicare Part D
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Open Enrollment Changes to Existing Coverage Special Enrollments Open Enrollment COBRA CHIP Enrollment Guidelines Membership at a Glance Member Resource Center - Widget Billing Forms Rx Center Tools and Resources Health & Wellness Newsletters Contact Us Health Care Reform for Employers
Cancellation of Coverage
Employees may choose to cancel their coverage at any time; they do not need to wait for an open enrollment period.
| type of cancellation | Required Form | Note |
|---|---|---|
| Voluntary | Group Enrollment Form marked "Voluntary Cancellation" | Employee must sign and date form |
| Employee leaves | Group Membership Update Form Keyword "LE" |
Group representative must sign and date form |
| Employee is ineligible for coverage | Group Membership Update Form Keyword "OTHER" |
Group representative must sign and date form |
IMPORTANT NOTE
Before you cancel coverage, you must thoroughly understand your company's responsibilities for continued coverage under federal or state law. Employees and dependents who lose coverage often have the right to continue receiving group benefits for a certain period of time. The law requires that you notify them promptly regarding their rights.
