Mid-Year Plan Changes
Generally, employees cannot change their plan, level of coverage, or dependent coverage until the annual Open Enrollment period which occurs every October. Applications for plan changes submitted during Open Enrollment will become effective January 1st of the next year upon review and approval by the State. There are exceptions when an employee may change coverage. These exceptions are:
• An employee who marries or enters into a civil union may enroll their spouse/partner and/or newly-eligible dependent children.
• When the birth or adoption of a child occurs. Adoption requires additional legal documentation filed with application.
• When a change in family status involving the loss of a family member occurs (divorce, death, loss of guardianship).
• The employee is on a leave of absence and cannot afford to pay for coverage. Coverage can be reduced from family to single or parent and child while employee is on the leave. When the employee returns to work, coverage can be increased back to family coverage.
• An employee’s spouse/partner loses health benefit coverage. The enrollment application must be accompanied by the spouse/partner’s HIPAA certification form showing the date coverage was lost.
If any of the above events occur, employees must submit a health benefits application to the Benefits Office within 60 days of the date of the life event. Otherwise, employees will be able to submit the application for plan change at the next Open Enrollment.
Kelly M. Vazquez
609-343-7200 Ext. 5058
Optum RX 844-368-8760
Aetna DEP (PPO) 877-782-8365
Aetna DPO (DMO) 800-843-3661
Horizon Dental (DPO) 800-433-6825
Metlife Dental (DPO) 866-880-2984
CIGNA Dental (DPO) 800-564-7642
HealthPlex Dental (DPO) 800-468-0600