Sec 125 Plan & Adult Child Coverage

[MrMaint]

What is the name of your state? IL

My company's open enrollment period for health care coverage was last Oct. During this period I chose the default option to keep my current coverage, but failed to see that I still had to declare my 20 year old daughter as a full time student. Because of this my company dropped my daughter from the plan effective Jan 1st. When I appealed this decision saying I didn't realize my daughter would be dropped from the plan if I selected the default option, my appeal was denied saying the plan had to operate under IRS Section 125 rules. I inquired about using the change in life status saying my daughter was now a full time student. I was informed that since she was also full time student last fall, there was no qualifying change in life status. So, my daughter gets dropped from insurance because I failed to declare her a full time student, and now I can't add her to the policy because she is a continuing full time student.

Is that how you would interpret the Section 125 guidelines? Do I have any other recourse?

Thank you.

 

[cbg]

I think they're being a bit picky but under a strict interpretation of Section 125 rules, they are correct. No, there's no way you can force them to pick her up now.

 

[Steve Shorr]

Section 125 Denial of Full Time Student

undefined

I would like to see a copy of the form that you completed at Open Enrollment before passing judgement. I was able to get coverage re-instated for a client of mine, as we were able to show the forms were ambiquous. The Employer cited section 125 rules too....

For more info see www.SteveShorr.com/section.125.htm and http://www.steveshorr.com/hss.appeal.htm