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 initially declined coverage for themselves or their dependents because they or the dependents were covered by other health insurance coverage, or the COBRA participant declined coverage for their 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:
Divorce
The employee or dependent is no longer eligible for coverage. Loss of coverage due to nonpayment of premiums does not qualify.
The employer unit ceased to contribute toward the cost of the other health plan, and it was terminated.
The employee's or dependent's COBRA continuation coverage eligibility has expired.
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. An enrollee adding coverage due to a special enrollment event may change coverage types (Base to Select, or Select to Base). There is no deductible or out-of-pocket credit if an enrollee changes coverage types during a calendar year.