Skip to main content
HelloFurther Learning Site

Qualifying Election Changes for a Premium Only Plan

Elections for any Plan Year can only be changed if you experience an Election Change Event and make an election change that is because of and consistent with the event called a “Qualifying Election Change”.

Requirements

You cannot elect an amount less than the amount you've already reimbursed. To change your election, you must request an election change with your Employer no later than 30 days after the Election Change Event.

The Election Change Event must affect eligibility for your health insurance, eligibility to participate in this Pre-Tax Premium Account, or eligibility of premiums for reimbursement (e.g. child no longer qualifies as your tax dependent). If you terminate your health insurance without an eligible Election Change Event, you will not be eligible to reduce your election amount.

Qualifying Events for Premium Only Plan

Corresponding increase or decrease to your Pre-Tax Premium Benefit:.

  • If your spouse or dependent:
    • Starts or ends a job
    • Increases or decreases work hours
    • Gains or loses eligibility for employer-sponsored health insurance and you change your Health Insurance status as a result.
  • A court order requires you or another person to provide Health Insurance
  • You, your spouse, or dependent gain or lose Medicare or Medicaid coverage
  • You change your Health Insurance status as a result of going on or returning from FMLA leave
  • There is a significant change in cost or coverage of your Health Insurance and you change your election
  • A mid-year election change is made by your spouse or dependent under their health insurance
  • Your spouse or dependent’s employer’s plan has a different plan year or period of coverage than this plan

Corresponding increase to your Pre-Tax Premium Benefit will occur if the type of Health Insurance you have changes because of:

  • Marriage
  • Birth or adoption of child

Corresponding decrease to your Pre-Tax Premium Benefit will occur if your Health Insurance Coverage Status changes due to:

  • Divorce
  • Child no longer qualifies as a dependent
  • Death of dependent

These are based on the interpretation of the applicable IRS regulations, however your Plan may be more restrictive. Talk to your benefits administrator for specific Plan details.

  • Was this article helpful?