Notice of Special COVID-19 Enrollment Opportunity
This notice contains important information about a change to your enrollment rights under your employer’s group health plan (the plan.) You should read this notice carefully and keep it in the same place where you keep other plan information.
This notice amends your Certificate of Coverage (CoC), and cafeteria plan document (as applicable) by changing your plan’s enrollment and benefit election provisions. The changes are effective April 1, 2020.
- Your employer or plan administrator is offering employees who have not enrolled in the Plan a Special COVID-19 Enrollment Opportunity. For the period of time described below, employees who did not previously enroll in the Plan will be allowed to elect coverage.
- Employees who previously elected self-only coverage will be able to change their election to include eligible dependents, such as spouses and children, so long as they are enrolled in the same coverage that you are enrolled in under the Plan.
- This is not an open enrollment period where all covered employees may change their existing benefit election. It is limited to the situations described in sections (a) and (b) above
If you wish to elect coverage under the Special COVID-19 Enrollment Opportunity, you will have from March 23, 2020 to April 6, 2020 to make the election. Coverage will be effective as of April 1, 2020, provided your employer or plan administrator receives your properly completed enrollment form and any required contribution for coverage during the special one-time enrollment period.
This Special One-Time Enrollment Opportunity expires as of April 6, 2020.