For groups with open enrollments, certain qualified events trigger special enrollment periods when an employee may change or add dependents outside of open enrollments. These events fall within three categories:

• Loss of coverage
• Changes in family status
• Changes in employment status

Allowed Changes

At the time of special enrollment, an employee/subscriber is allowed to:

• Switch to any of the health coverage options offered by the group, not only the one which he/she is currently enrolled
• Change or add dependents
• Upgrade membership type (if necessary)

Request for Change

• Completed Group Enrollment Form - signed and dated by employee
• Additional documentation (if required)
  

Most Common Qualified Events & Effective Dates

• The most common qualified events
• The effective date based on BCBSVT's receipt of the completed group enrollment form and proper documentation (if required)

Event	Form Received		Effective Date		GBM Reference
Marriage/Civil Union	Within 31 days following marriage/civil union.		First of the month following marriage/civil union.		S1 - pg. 22
	32 to 60 days following marriage/civil union.	First of the month following receipt.			S1 - pg. 22
	After 61 days following marriage/civil union.	Void - employee must wait until next open enrollment to add dependent(s).
Birth/Adoption	Within 31 days following birth.		Date of birth for child and 32nd day after the birth for the membership type change.		S1 - pg. 23
	32 to 60 days following birth.	First of the month following receipt.			S1 - pg. 23
	After 61 days following birth.	Void - employee must wait until  next open enrollment to add dependent(s).
Divorce	Within 60 days of divorce.		First of the month following divorce.		S1 - pg. 27
Qualifying Loss  of Coverage	Along with additional documentation, within 31 days after loss of coverage.		Retroactive to date of coverage loss.		S1 - pg. 27

More Information

Refer to the "Special Enrollments" section of the Group Benefits Manager's Manual.