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Notice of Special Enrollment Rights

Generally, you are permitted to enroll or make changes to your enrollment in Monmouth University’s group health plans (for example, the medical or dental plans) during your initial eligibility (following a waiting period once hired into a benefits eligible position) or annually during our Open Enrollment period.  The Monmouth University Open Enrollment period occurs annually October through November with a January 1 effective date of coverage.

However, if you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in the University’s health plans if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage) due to a Qualifying Status Event. Additionally, you qualify for a Special Enrollment due to marriage or the birth, adoption or placement for adoption of a child allowing you to add or change your existing coverage. Depending on the event, you may qualify to make certain corresponding benefit enrollment changes with written notification to the Office of Human Resources within 30 days of the loss of coverage or life event triggering the special enrollment (60 days of the loss of coverage or the determination of eligibility for premium assistance for Medicaid or NJ Family Care).

Some examples of Special Enrollment Events include:

  • An individual loses eligibility for coverage under a group health plan or other health insurance coverage (such as an employee and his/her dependents’ loss of coverage under the spouse’s plan) or when an employer terminates contributions toward health coverage;
  • An individual loses coverage under a group health plan covered through COBRA continuation due to the exhaustion of the COBRA period;
  • An individual becomes a new dependent through marriage, birth, adoption, or being placed for adoption; and
  • An individual loses coverage under a State Children’s Health Insurance Program (CHIP) or Medicaid, or becomes eligible to receive premium assistance under those programs for group health plan coverage.

For these Special Enrollment events as well as any change of address, telephone number(s) or contact update please submit a Change of Status Form to the Office of Human Resources. Keep in mind that not all changes are automatic so please consult with one of the University’s benefits specialist for direction.

Additional examples of Special Enrollment Events include:

A life event change, also called a qualifying event, is a personal change in status which may allow you to change your benefit elections. Examples of some qualifying events include, but are not limited to, the following:

  1. Change in legal marital status – marriage, divorce, legal separation, annulment, or death of a spouse
  2. Change in number of dependents – birth, death, adoption, placement for adoption, award of legal guardianship
  3. Change in employment status of the employee’s spouse or employee’s dependent – switching from part-time to full-time employment status or from full-time to part-time, termination or commencement of employment, a strike or lockout, commencement of or return from an unpaid leave of absence which results in employee/dependent becoming ineligible for coverage
  4. Dependent child reaches the age of 26
  5. Loss of coverage due to expiration of COBRA continuation period

Time Frames and Effective Dates

If you experience a Special Enrollment event, you will need to request a change, in writing, to the Office of Human Resources within 30 calendar days (60 days due to loss of eligibility or premium assistance through Medicaid or NJ Family Care) of the event and provide any required documentation. Required documentation may include a marriage, birth or adoption certificate as appropriate. In the case of loss of coverage in other health insurance plan, documentation from the insured party’s employer specifying type of coverage, reason for loss of coverage along with who was covered under the plan is also required. If you do not request the change within 30 calendar days (60 for loss under Medicaid or NJ Family Care), the next opportunity you will have to make changes to your benefits will be during the next open enrollment period.

Additional information and FAQ’s can be accessed at the US Department of Labor’s Compliance Assistance web site.

** Please note that if the University is not notified within the time parameters outlined above resulting in the University incurring expenses, such expenses will be the responsibility of the employee

Updating Your Beneficiary

When you have a qualifying status event change, it is also a good time to review your beneficiary whom you have designated to receive benefits in the event of your death.

Changes in your family situation, as a result of a qualifying status event, do not automatically alter or revoke your previous beneficiary designations. Beneficiary designations made prior to the qualifying status event remain intact until you complete a new beneficiary form.

You may wish to consider updating your life insurance and/or your TIAA retirement plan beneficiaries. Beneficiary forms for life insurance may be obtained from the Office of Human Resources. Beneficiary updates to your 403(b) Retirement Plan must be made directly with TIAA (or with your previous 403(b) vendor).