Oklahoma Administrative Code › Title 260 - Office of Management and Enterprise Services › Chapter 40 - Employee Benefits Department › Subchapter 17 - Benefit Plan Election › Section 260:40-17-4 - Changes to benefit elections

Current through Vol. 41, No. 20, July 1, 2024
(a) A
				participant may change an election only in accordance with the provisions of
				this Plan. This Section does not remove the requirement that every employee
				must enroll in at least the basic plan of coverage except for those employees
				declining participation pursuant to
				260:40-17-3(c)(1).
(b) All requests for changes submitted to the
				Plan Administrator must be in a format as determined by the Plan
				Administrator.
(c) Provided that
				all other eligibility requirements are met, and written or electronic notice is
				provided to the Plan Administrator within thirty (30) days of a qualifying
				event, including receipt of a Qualified Medical Child Support Order, the
				effective date of such change of benefits coverage will be the first of the
				month following receipt of acceptable notice as determined by the Plan
				Administrator as long as the correct premium is paid. All enrollments and
				elections are for the entire Plan Year and are irrevocable during same Plan
				Year unless a change is requested based on one of the following permitted
				exceptions to the irrevocability rule. A change must comply with the IRS
				consistency rule as found in Treasury Regulations 1.125-4 as may be amended.
				Only the permitted exceptions provided for in this chapter shall be allowed as
				changes to benefits elections unless those changes are prohibited under the
				Premium Conversion Option, the Dependent Care Reimbursement Account Option or
				the Health Care Reimbursement Account Option as provided for in subchapters 23,
				25, and 27 respectively. All changes shall become effective on a prospective
				basis and not earlier than the first day of the month following receipt of
				acceptable notice of the requested change which must be on account of and
				corresponding with the event with the exception of termination of coverage for
				a spouse and/or dependents who have ceased to satisfy eligibility as a result
				of death, which shall become effective the first of the month following the
				date of the event. Permitted exceptions to the irrevocability rule as allowed
				within Plan guidelines are as follows:
(1)
				HIPAA Special Enrollment Rights (marriage, birth, adoption or placement for
				adoption, loss of other coverage including exhaustion of COBRA
				coverage)
(2) Change in Employee's
				Legal Marital Status
(3) Change in
				the Number of Employee's Dependents
(4) Change in Employment Status of Employee,
				Spouse or Dependent that affects eligibility
(5) Event Causing Employee's Dependent to
				satisfy or cease to satisfy Eligibility Requirements
(6) Change in Place of Residence of Employee,
				Spouse or Dependent
(7)
				Commencement or Termination of Adoption Proceedings
(8) Judgments, Decrees or Orders (changes
				allowed only to Health, Health Care Reimbursement Account and Dental)
(9) Medicare or Medicaid (changes allowed
				only to Health and Health Care Reimbursement Account)
(10) Significant Change in Cost or a Change
				in Coverage (changes allowed only to Dependent Care Reimbursement
				Account)
(11) Changes in Coverage
				of Spouse or Dependent under Other Employer's Plan
(12) FMLA Leave
(13) Such other events, which may permit such
				modification or election under the IRS consistency rule as found in Treasury
				Regulations 1.125-4 and in accordance with other applicable and prevailing
				Internal Revenue Code regulations promulgated thereunder, and in accordance
				with this chapter.