Source: https://employers.healthreformquotes.com/ab-1083/waiting-period/special-open-enrollment/federal/
Timestamp: 2020-07-11 16:48:04
Document Index: 608039004

Matched Legal Cases: ['§ 54', '§ 54', '§ 54', '§ 54', '§ 54', '§ 54']

Federal Late - Special Enrollment - QLE Rules CFR § 54.9801-6 Employer Group Health Plans Federal Late - Special Enrollment - QLE Rules CFR § 54.9801-6 Employer Group Health Plans
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Federal Special enrollment — loss of Employer Coverage CFR § 54.9801-6
See our page Late Enrollee – Trigger – Qualifying Events for a more plain English explanation for California
(2) Individuals eligible for special enrollment —
(i) When employee loses coverage.
A current employee and any dependents (including the employee’s spouse) each are eligible for special enrollment in any benefit package under the plan (subject to plan eligibility rules conditioning dependent enrollment on enrollment of the employee) if—
(ii) When dependent loses coverage —
(A) A dependent of a current employee (including the employee’s spouse) and the employee each are eligible for special enrollment in any benefit package under the plan (subject to plan eligibility rules conditioning dependent enrollment on enrollment of the employee) if—
(3) Conditions for special enrollment —(i) Loss of eligibility for coverage.
(ii) Termination of employer contributions.
In the case of an employee or dependent who has coverage that is not COBRA continuation coverage, the conditions of this paragraph (a)(3)(ii) are satisfied at the time employer contributions towards the employee’s or dependent’s coverage terminate. Employer contributions include contributions by any current or former employer that was contributing to coverage for the employee or dependent.
(iii) Exhaustion of COBRA continuation coverage.
In the case of an employee or dependent who has coverage that is COBRA continuation coverage, the conditions of this paragraph (a)(3)(iii) are satisfied at the time the COBRA continuation coverage is exhausted. For purposes of this paragraph (a)(3)(iii), an individual who satisfies the conditions for special enrollment of paragraph (a)(3)(i) of this section, does not enroll, and instead elects and exhausts COBRA continuation coverage satisfies the conditions of this paragraph (a)(3)(iii). ( Exhaustion of COBRA continuation coverage is defined in § 54.9801-2.)
§ 54.9802-1(d) Similarly situated individuals . [How to tell???]
The requirements of this section apply only within a group of individuals who are treated as similarly situated individuals. A plan may treat participants as a group of similarly situated individuals separate from beneficiaries. In addition, participants may be treated as two or more distinct groups of similarly situated individuals and beneficiaries may be treated as two or more distinct groups of similarly situated individuals in accordance with the rules of this paragraph (d). Moreover, if individuals have a choice of two or more benefit packages, individuals choosing one benefit package may be treated as one or more groups of similarly situated individuals distinct from individuals choosing another benefit package.