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elaws - employment laws assistance for workers and small businesses

- Health Benefits Advisor for Employers

Determining Compliance with the HIPAA Provisions in Part 7 of ERISA

Compliance with the Special Enrollment Provisions - Dependents

Does the plan provide full special enrollment rights to individuals upon marriage, birth, adoption, and placement for adoption?

Plans must generally permit current employees to enroll upon marriage and upon birth, adoption, or placement for adoption of a dependent child. See ERISA section 701(f)(2); 29 CFR 2590.701-6(b)(2).

Plans must generally permit a participant's spouse and new dependents to enroll upon marriage, birth, adoption, and placement for adoption. See ERISA section 701(f)(2); 29 CFR 2590.701-6(b)(2).

Plans must allow an individual a period of at least 30 days to request enroll- ment. See 29 CFR 2590.701-6(b)(3)(i).

In the case of marriage, coverage must become effective no later than the first day of the month following a completed request for enrollment. See 29 CFR 2590.701-6(b)(3)(iii)(A).

In the case of birth, adoption, or placement for adoption, coverage must become effective as of the date of the birth, adoption, or placement for adoption. See 29 CFR 2590.701-6(b)(3)(iii)(B).

Tips: Remember to allow all eligible employees, spouses, and new dependents to enroll upon these events. Also, ensure that the effective date of coverage complies with HIPAA, keeping in mind that some effective dates of coverage are retroactive.