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When Can I Make Changes to My Insurance?
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Dane Pisano

 

Scrabble letters spell “time for a change”

With the Open Enrollment period started, is it time for you to make changes to your health insurance? Image credits : Alexas_Fotos via Pixabay.

The rules governing when someone can change their health insurance policy are relatively straightforward, but may seem confusing or arbitrary to someone who has not had their own health coverage before. In this article, Garnett-Powers & Associates give a clear explanation of when a change in policy is possible.

 

When Health Policy Changes are Allowed

It can occur that a postdoc learns there are other policy options available to them that they would prefer to have. Thay decide one day that they want to make changes to their current health insurance coverage, so they go to their plan administrator only to find out that they can’t. The administrator tells them that they need to wait for something called a “Qualifying Event” or “Open Enrollment.” What are those, they may wonder?

 

Well, there are very specific times that an individual can make changes to their coverage. These include:

 

Period of Initial Eligibility (PIE)

PIE might sound delicious, but in this case it is referring to the period of initial eligibility, that is the period (typically the first 31 days) following the date the postdoc become eligible for coverage. For instance, if a postdoc became eligible for coverage on 5/1/2018, they are permitted to enroll and make changes to their benefits until 5/31/2018. Beginning 6/1/2018 they are no longer allowed to make changes and would need to wait until they or a dependent experience a qualifying event, or for the annual open enrollment period.

 

Qualifying Event (QE)

A Qualifying Event is a significant life event that grants the postdoc a unique 31-day window to make changes to their coverage outside of their PIE or Open Enrollment. The 31-day window begins on the date of the qualifying event, and documented proof is often required. Qualifying events typically include:

  • Marriage
  • Divorce
  • Birth of a child
  • Adoption
  • Loss of prior coverage
  • Relocation
  • Entrance into the United States

For example, if a postdoc got married on 7/1/2018, they would be permitted to enroll or make changes to their benefits until 7/31/2018. Beginning on 8/1/2018, they would no longer be allowed to make changes until another qualifying event or the annual open enrollment period.

 

Open Enrollment (OE)

Open Enrollment is an annual period, typically several months before that start of the new plan year, where everyone eligible for coverage is permitted to make changes to their plan(s). This is the time of year where the postdoc can change their plan from the HMO to the PPO (or vice-versa), enroll themself or dependents they previously waived, waive coverage they no longer want, or make any other allowable change. The Open Enrollment period is typically only a few weeks long, and the changes made take effect at the start of the new plan year.

 

Knowing this information can help postdocs carefully weigh changes to their coverage and assists them with planning for their specific needs in the future. But the postdoc should not stop here in their quest for knowledge about health coverage. Contacting a qualified representative at Garnett-Powers & Associates before open enrollment or a qualifying event will help them better navigate their choices to plan for the strongest possible future.

 

Dane Pisano is an account manager at Garnett-Powers & Associates, Inc.

 

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