Divorce

Divorce or Legal Separation Benefit Choices & Considerations for Your Recent Life Event If You’re an NCFlex Participant: • Contact your Health Benefits Representative (HBR) or benefits department to make benefits 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. • When you legally separate, and have been living apart from your spouse at least 90 days but are not yet divorced, you have the option to terminate your former spouse, children and stepchildren (if applicable) from your coverage. • When you divorce, your former spouse (and your children or stepchildren, if applicable) is no longer eligible for benefit coverage. When coverage for your former spouse and children ends, they may be able to continue health coverage under COBRA for 36 months (until the end of the plan year for the HCFSA). • If you are losing benefit coverage under your spouse’s plan, you may be eligible to continue your coverage. Ask your spouse’s employer for information and a HIPAA portability certificate. • Some benefit changes may be subject to a waiting period or Evidence of Insurability (EOI). Life Events YOUR STATE BENEFIT DECISIONS As a result of your divorce or legal separation, some of your bene ts are required to change. You may also make other elective bene t changes. The following chart lists considerations by bene t and action steps you should take. FOR: STATE HEALTH PLAN CONSIDER THESE OPTIONS: • Drop coverage for your spouse, children or stepchildren (you may change your coverage tier). • Add coverage for yourself and/or eligible dependents if losing coverage under spouse’s medical plan (you may change your coverage tier). TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment 1. Complete the Change Form and Prior Health Coverage Information Form if you are adding eligible dependents. Forms may be found on www.shpnc.org under Important Forms, Update Your Information or request one from your HBR. 2. Submit the completed forms to your HBR within 30 days of the ineligibility or life event. Failure to do so within 30 days may result in a waiting period or penalty, forfeiture of refundable premiums, and loss of eligibility for continuation of coverage. 1. Notify your HBR within 30 days of the ineligibility or life event. Your HBR will create an enrollment event so you may make changes online. 2. If you are adding dependents, complete the Prior Health Coverage Information Form found on www.shpnc.org under Important Forms, Update Your Information and submit the form to your HBR. Important Notes: • If notification is not made within 30 days following the spouse’s or dependent’s ineligibility event, the spouse and dependent will be retroactively removed the first of the month following the ineligibility event, and the coverage type change will be effective the first of the month following written notification. For example, if your divorce is final or written notification is provided on April 15, your ex-spouse will be removed effective May 1. • Your legally separated or divorced spouse and dependents may be eligible for continuation of coverage under COBRA or to convert to a non-employer sponsored plan the first day of the month following the ineligibility event. • You may not make a change in medical plan (for example, Basic to Plus option). • Drop coverage for your spouse, children or stepchildren, however employee must remain active. • Add coverage for yourself and/or eligible dependents if losing similar coverage under spouse’s dental plan. Online Enrollment Continuation of Coverage COBRA election forms will be mailed to you. Complete the COBRA election forms and return them within 60 days of the ineligibility event. NCFLEX DENTAL Form Enrollment / Beacon Enrollment Important Note: 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Submit the completed form and a copy of your legal separation/ divorce decree 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 a copy of your legal separation/divorce decree to your HBR. You may not make a change in dental option (for example, Low to High Option). Online Enrollment www.ncflex.org Divorce or Legal Separation Benefit Choices & Considerations for Your Recent Life Event A FEW THINGS TO CONSIDER: FOR: NCFLEX VISION CARE CONSIDER THESE OPTIONS: • Drop coverage for your spouse, children or stepchildren. • Add coverage for yourself and/or eligible dependents if losing similar coverage under spouse’s vision care plan. Life Events • Are you and/or your dependents covered under your former spouse’s benefit plans and now need coverage under the State’s benefit plans? • Has a court order been issued for child support or alimony as part of your divorce agreement? • Do you want to change your name? Contact the Social Security Administration or visit www.ssa.gov for information on getting a new Social Security card. Remember to check and/or change other forms of identification as well (i.e., driver’s license, passport, credit/ debit cards, insurance cards, etc.) • Do you want to change your mailing address? Contact your HBR and/or payroll office. Remember to notify your local post office about your new address and possible name change. • Do you need to make changes to direct deposit forms, bank account information and/or income tax withholding (W-4 form) on your paycheck? Contact your HBR and/or payroll office. • Do you want to update your estate documentation, will, power of attorney and beneficiary information? If you don’t have any of these, consider contacting an attorney to prepare them. • Consider reviewing your life insurance and disability coverage needs. 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 and a copy of your legal separation/ divorce decree 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 a copy of your legal separation/divorce decree to your HBR. 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Submit the completed Family/Employment Status Change Form and a copy of your legal separation/divorce decree 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 a copy of your legal separation/divorce decree to your HBR. Online Enrollment NCFLEX CANCER • Drop coverage for your spouse, children or stepchildren. • Add coverage for yourself and/or eligible dependents if losing similar coverage under spouse’s cancer plan. • Change your cancer option. • 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 will be required if: – you declined cancer coverage when it was first offered to you and your dependents and now you want to add it; 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. Form Enrollment / Beacon Enrollment Important Notes: Online Enrollment 2 • Do you want to change your supplemental retirement plan withholding amount? • 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. FOR: NCFLEX ACCIDENTAL DEATH AND DISMEMBERMENT AD&D CONSIDER THESE OPTIONS: • Add or increase your coverage amount. • Add/drop family coverage. TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment Important Note: • If you elect family coverage and a family member suffers a loss, the benefit paid is a percentage of your principal sum. • If you are a pilot or crew member for the State, your benefit is limited and the cost is higher. 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 and a copy of your legal separation/ divorce decree 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 a copy of your legal separation/divorce decree 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 a copy of your legal separation/divorce decree 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 a copy of your legal separation/divorce decree to your HBR. 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Submit the completed form and a copy of your legal separation/ divorce decree 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 a copy of your legal separation/divorce decree to your HBR. Online Enrollment NCFLEX GROUP TERM LIFE • Add or increase your coverage amount. • Drop 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 and now you want to add it; 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 • Enroll in or increase your contributions to the account. • Drop or decrease contributions to the account. 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 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 Divorce or Legal Separation Benefit Choices & Considerations for Your Recent Life Event YOUR BENEFIT DECISIONS FOR: NCFLEX DEPENDENT DAY CARE FLEXIBLE SPENDING ACCOUNT DDCFSA CONSIDER THESE OPTIONS: • Enroll in or increase your contributions to the account. • Drop or decrease contributions. Life Events TAKE THESE ACTIONS: Form Enrollment / Beacon Enrollment 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. • Consider adding the NCFlex Convenience Card for you and your 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. • Update your name and address. 1. Complete the Family/Employment Status Change Form found on www.ncflex.org under Resources, Forms. 2. Submit the completed form and a copy of your legal separation/ divorce decree 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 a copy of your legal separation/divorce decree to your HBR. 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. 3. Contact your HBR to update your name and address. State Health Plan North Carolina Teachers’ and State Employees’ Comprehensive Major Medical Plan www.ncflex.org 4