A question has come up regarding adding dependents following a family status change. Scenario is this, an employee is enrolled as employee only but has children that are not currently enrolled in the group plan. The employee has a family status change, gets married, and makes a mid year change from single to family coverage. Can he add dependents, the children not covered previously, and new dependents at the same time or will the children he had not previously covered have to wait for the next open enrollment period?

This situation implicates the "special enrollment rights" established by HIPAA, not only "family status changes" under cafeteria plans. Whether the employee can now enroll children not previously covered as dependents (in addition to the new spouse and any new dependents) may depend on why he previously declined coverage. The applicable regs (see 29 CFR sect. 2590.701-6) set out in some detail the circumstances under which employees and dependents must be allowed to enroll outside of a plan's open enrollment periods.

I think under ERISA 701(f)(2), you are only required to permit enrollment of the new dependents. However, your plan might be more liberal.

I agree with Hillary P. I didn't see her post before I made my reponse. Hillary's answer addresses the possibility that there might have been two events, the marriage and a loss of other coverage.

The employer is a government entity, not bound by ERISA, and the plan does not require a statement from the employee as to why a dependent was not enrolled.

In reviewing 701-6, the "requirements" of the legislation would indicate that only those affected by the event (a)(3) dependent that looses coverage or (B)(5) dependent from marriage, birth ...

Could the plan "allow" othe dependents to be added?

[This message has been edited by nb (edited 09-24-1999).]

[This message has been edited by nb (edited 09-24-1999).]