Each October during the annual open enrollment period, an employee may choose to elect coverage for himself and/or his eligible dependent(s). The coverage elected during open enrollment takes effect on January 1 of the following calendar year.
Special Enrollment Periods
An employee, dependent of a covered employee, or dependent of a COBRA participant who loses coverage under another health plan will be eligible to enroll for coverage in the Plan if the following apply:
The employee declined coverage for himself or his dependents when first eligible because the employee or dependent was covered by other health insurance coverage; or the COBRA participant declined coverage for his dependent when first eligible because the dependent was covered by other health insurance coverage
The employee or dependent lost other coverage as a result of any of the following qualifying events:
The employee or dependent is no longer eligible for coverage (Loss of coverage due to non-payment of premiums does not qualify.
The employer ceased to contribute toward the cost of the other health plan, and it was terminated.
The employee's or dependent's COBRA continuation has run out.
To enroll for coverage under these circumstances, an Application for Coverage form must be submitted within 60 days of losing coverage under the other plan and appropriate premiums must be paid. As part of the application process, proof of loss of coverage must be provided. If these requirements are met, coverage under the Plan will take effect the first day following the loss of other coverage.