Dependent Death

Dependent Death Death of Spouse or Child Benefit Choices & Considerations for Your Recent Life Event If You’re an NCFlex Participant:Contact your Health Life Events YOUR STATE BENEFIT DECISIONS FOR: STATE HEALTH PLAN Benefits Representative (HBR) or benefits department and make coverage changes within 30 days of your family status change. Changes are effective the first of the month following the date of the event. Online enrollment participants may make changes online. • The changes you request must be consistent with your life event and you may be required to provide documentation to your HBR. • Some benefit changes may be subject to a waiting period or Evidence of Insurability (EOI). • When canceling coverage, coverage continues through the end of the month, provided there are adequate payroll deductions to cover the premium costs. Flexible spending accounts end on the earlier of the termination/loss of coverage date, or the last month a contribution was payroll deducted. The death of a spouse or child is a tremendous loss. Although this is a di cult time, it may be necessary to consider making changes to your bene ts. The following chart lists considerations by bene t and action steps you should take. CONSIDER THESE OPTIONS: • Drop coverage for your deceased spouse or child (you may change your coverage tier). TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment 1. Complete the Change Form found on www.shpnc.org under Important Forms, Update Your Information, or request one from your HBR. 2. Submit the completed form to your HBR within 90 days of the life event. 1. Notify your HBR within 90 days of the life event. Your HBR will create an enrollment event so you may make changes online. 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Submit the completed form along with proof of death to your HBR within 30 days of the life event. Important Notes: • Notify your HBR when there is a change in eligibility. • Coverage level changes will be made retroactive to the first of the month following the date of death. • You may not make a change in medical plan (for example, Basic to Plus option). • Add coverage for yourself and/or eligible dependents if losing coverage under spouse’s dental plan. Online Enrollment NCFLEX DENTAL Form Enrollment / Beacon Enrollment Important Notes: • You may not make a change in dental plan option (for example, Low to High Option). • Drop coverage for your deceased spouse or child. Online Enrollment 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. 4. Submit proof of death to your HBR. www.ncflex.org Death of Spouse or Child Benefit Choices & Considerations for Your Recent Life Event A FEW THINGS TO CONSIDER: FOR: NCFLEX VISION CARE Life Events CONSIDER THESE OPTIONS: • Drop coverage for your deceased spouse or child. • Add coverage for yourself and/or eligible dependents if losing similar coverage under spouse’s vision plan. TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Submit the completed form along with proof of death to your HBR within 30 days of the life event. • Contact your supervisor and HBR immediately. They will work with you to coordinate filing claims, payment of benefits and leave time. • Contact the Social Security Administration or visit www.ssa.gov for information on benefits available to you. • Did your deceased spouse cover you and/or your children through his/her employer’s benefit plan? You’ll need to contact his/her employer to find out how to file life, AD&D, health and disability claims. You’ll be given options to continue coverage for you and your children under COBRA. You may also move your family members to the State benefit plans. Make sure you receive a HIPAA portability certificate and do not have a 63 day or more gap in coverage for the State Health Plan. • Consider contacting your Employee Assistance Program (EAP) for confidential counseling, information and referrals. • If you participate in any other plans sponsored by your employer (such as dental, life or cancer), check with the plan administrator to see what your options are and what steps you need to take. • Please check if your agency, university or community college sponsors any additional benefit plans that may be impacted by your recent life event. Online Enrollment 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. 4. Submit proof of death to your HBR. 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Visit www.ncflex.org for the EOI form. 3. Submit the completed forms along with proof of death to your HBR within 30 days of the life event. 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. Complete EOI information during enrollment process when prompted. 4. Submit proof of death to your HBR. NCFLEX CANCER • Drop coverage for your deceased spouse or child. • Add coverage for yourself and/or eligible dependents if losing similar coverage under spouse’s cancer plan. • Change your cancer option. Form Enrollment / Beacon Enrollment Important Notes: • If you or your spouse/dependents are eligible for Medicaid, benefits assigned under the policy are required to be assigned back to Medicaid, so this may not be your best choice. • EOI may be required if: – you declined cancer coverage when it was first offered to you and your dependents; or – you change to a higher option. • EOI must be approved within 60 days after form is signed or it is automatically denied. Coverage is effective the first day of the month after EOI is approved by the vendor. For example, if you are approved on May 16, coverage is effective June 1. Online Enrollment 2 FOR: NCFLEX ACCIDENTAL DEATHAND DISMEMBERMENT AD&D CONSIDER THESE OPTIONS: • Add coverage or increase your coverage amount. • Add/drop family coverage. TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. Be sure to complete or update beneficiary information. 2. Submit the completed form along with proof of death to your HBR within 30 days of the life event. 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. Complete EOI information during enrollment process when prompted. Be sure to update your beneficiary information. 4. Submit proof of death to your HBR. 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. Be sure to complete or update beneficiary information. 2. Visit www.ncflex.org for the EOI form. 3. Submit the completed Family/Employment Status Change Form, EOI form and proof of death to your HBR within 30 days of the life event. 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. Complete EOI information during enrollment process when prompted. Be sure to update your beneficiary information. 4. Submit proof of death to your HBR. 1. Complete the Family/Employment Status Change Form and Convenience Card enrollment forms (if applicable), found on www.ncflex.org under Resources, Forms. 2. Submit the completed forms along with proof of death to your HBR within 30 days of the life event. 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. 4. Submit proof of death to your HBR. Important Notes: • If you elect family coverage and a family member suffers a loss, the benefit paid is a percentage of your principal sum. • If your spouse is an employee of a state agency, university or select community college, only one of you may elect family coverage. An employee may not be covered as, both an employee and a dependent. • If you are a pilot or crew member for the State, your benefit is limited and the cost is higher. Online Enrollment NCFLEX GROUP TERM LIFE • Add coverage or increase your coverage amount. • Drop coverage or decrease your coverage amount. Form Enrollment / Beacon Enrollment Important Notes: • EOI will be required if: – you declined Group Term Life coverage when it was first offered to you; or – you increase your existing coverage amount. • EOI must be approved within 60 days after form is signed or it is automatically denied. Coverage is effective the first day of the month after EOI is approved by the vendor. For example, if you are approved on May 16, coverage is effective June 1. Online Enrollment NCFLEX HEALTH CARE FLEXIBLE SPENDING ACCOUNT HCFSA • Drop or decrease your contributions to the account. • Enroll or increase your contributions to the account if losing coverage under your spouse’s HCFSA plan. Form Enrollment / Beacon Enrollment Important Notes: • Health care expenses incurred prior to your effective date under the HCFSA or outside of the plan year are not eligible for reimbursement. • Reimbursement of expenses incurred prior to the change date will be limited to your original account maximum and not to the new higher maximum. • Consider adding the NCFlex Convenience Card for you and your spouse/dependents, so you do not have to wait for reimbursement. • Changes to your contribution amount are subject to the annual minimum of $120 and maximum of $4,200. Online Enrollment www.ncflex.org 3 Dependent Death Death of Spouse or Child Benefit Choices & Considerations for Your Recent Life Event FOR: NCFLEX DEPENDENT DAY CARE FLEXIBLE SPENDING ACCOUNT DDCFSA Life Events CONSIDER THESE OPTIONS: • Enroll or increase your contributions to the account. • Drop or decrease contributions to the account. TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment 1. Complete the Family/Employment Status Change Form and Convenience Card enrollments forms (if applicable), found on www.ncflex.org under Resources, Forms. 2. Submit the completed form along with proof of death to your HBR within 30 days of the life event. 1. Log onto www.ncflexonline.org and click on My Account. 2. Select Add Life Status Change Event and select the appropriate event from the drop down menu. 3. Follow the instructions displayed to complete the transaction. This transaction opens the website for 30 days for benefit changes from the date of your life event. 4. Submit proof of death to your HBR. Important Notes: • Dependent day care expenses incurred prior to your effective date under the DDCFSA or outside of the plan year are not eligible for reimbursement. • Reimbursement of expenses incurred prior to the change date will be limited to your original account maximum and not to the new higher maximum. • The IRS limits a family filing a joint return to a maximum of $5,000 of DDCFSA deductions per calendar year. This includes your new spouse’s employer plan contributions. • Consider adding the NCFlex Convenience Card for you and your spouse/dependents, so you do not have to wait for reimbursement. • Changes to your contribution amount are subject to the annual minimum of $120 and maximum of $5,000. • Review your beneficiaries. Online Enrollment STATE RETIREMENT 1. Contact the Retirement System to review your beneficiaries. 2. If you wish to change your beneficiary(ies), complete Designating Beneficiaries for Retirement System Contributions Form 2C found on www.myncretirement.com or obtain by calling 1-877-627-3287 (toll free) or 1-919-807-3050 in Raleigh. State Health Plan North Carolina Teachers’ and State Employees’ Comprehensive Major Medical Plan www.ncflex.org 4