Can You Switch Your Spouse's Employee Benefits Policy Mid-Year?

In today's competitive job market, employers need to offer strong benefits packages in order to attract and retain top talent. Offering health insurance coverage that extends to the employee’s spouse and dependent children is a perk that will make your company more desirable to work for.

Assuming that you get the timing right, it's easy for an employee to add his or her spouse to the company's health insurance plan. The optimal time to do this is during the company's open enrollment. However, there will be times outside of the open enrollment period that an employee may need to add a spouse or dependent child to the group health insurance policy due to something that has happened in their life, triggering that need. For that reason, your employees should know that there are several life events that qualify them for a special enrollment period.  

A special enrollment period is usually defined as the 31 days following the occurrence of one of these qualifying events. Here are several examples of life events for which you must allow an employee to enroll a spouse or dependent child into his or her health plan mid-year:

1. A spouse or dependent child loses minimum essential coverage due to loss of job, termination of COBRA, a death, or any other involuntary termination of previous health insurance coverage.

2. If your employee gets married, the new spouse and any new step-children acquired through the marriage become eligible to enroll.

3. If your employee acquires a new child through birth or adoption.  

4. A court order- such as decreed during divorce, in a child support or custody hearing, or a newly appointed legal guardianship can also open a special enrollment period.

There can be some misinterpretations surrounding the life events that grant access to a special enrollment period for a group health insurance policy mid year. Rules do also vary for individual health insurance policies, which can sometimes cause confusion as well.  

Our experienced team at Summerlin Benefits Consulting is here to help you provide your team with a comprehensive employee benefits package that is strategically designed to meet and exceed your objectives. We support our clients with a variety of enrollment services to address important questions such as Qualifying Life Events and Special Enrollment Periods. Please contact us to learn more about putting together a custom tailored employee benefits package that will best meet the needs of your employees and your company's budget.