Qualifying Events, Re-Instatements/Settlement Agreements, Job Data - PowerPoint PPT Presentation

Qualifying Events, Re-Instatements/Settlement Agreements, Job Data Entry, Flexible Spending, and Special Announcement

Qualifying Events ■ Un Under der IRS S Gui uidel elines ines, an emplo loyer r may allow w emplo loyee ees to elect ect certain tain benef enefit its on a pre- tax basis. These arrangements are considered “Cafeteria Plans. "Which are sub ubject ject to certain tain gui uidel deline ines s and rul ules. s. Un Unde der a c cafeteria ia plan, , an emplo loyee ee can change nge thei eir r pre-ta tax x deferr rral al electi ction on dur uring ng the e Open en En Enrol ollme lment nt Period od or in the e case of a “Qualifying Event.” Employees must sub ubmit mit an electr ectron onic ic enroll ollment ment form rm withi hin n 31 days of a Qu Qualify fying ing Ev Event nt in order der to make e a related ed bene nefit it change nge. ■ https://www.mybenefitsnm.com/Enrollment.htm – Gold tab at the top “Enrollment” ■ The e follo lowing ing se secti tions ons provi vide de an overvi view w of IRS S Qu Qualify fying ing Ev Events nts and the corre respon ponding ding bene nefits ts that can be changed nged for each h event. ent.

Quali ualifying fying Ev Even ents ts Continued ntinued  Permitt rmitted d cafeteri ria plan change nges s based sed on n specif ecific ic Quali lifyi fying ng Events nts are re as fo follo lows: ws: – Change nge in job b statu tus s of spou ouse se/do /domestic tic partne ner r resu sult lting ing in loss s of gro roup p cover erage ge or gain in of ot other r cover erage fro rom new w empl ploym yment nt. – Change nge in job b statu tus s of empl ployee (such as redu duction tion of hours s due to FMLA, LWOP OP, , and d Disabil ility ity). ). – Marriag rriage e or a chang nge in mari rita tal l statu tus, s, such as divor orce e or lega gal l separa paratio tion, n, resu sult lting ing in a loss s of cover erage. This s include ludes satis tisfyi fying ng requir irement nts s fo for r Domestic tic Partne nersh ship ip elig igibi ibili lity ty. . – Death of the e empl ployee ee. . *Death eath of a spouse se or eligib ible le depen ende dent, t, resu sult ltin ing in a loss s of group coverage. e. – Birth th of a child ld, , a court t app pproved ed adop optio tion n or lega gal l guardia diansh ship ip. – Any y oth other er circ rcumsta tanc nce e wher ere the e indivi dividu dual l had d oth other er cover erage e and nd loses ses it due e to circumsta tanc nces beyond nd thei eir r contr ntrol ol must t be eva valuat luated by RMD D fo for r elig igib ibil ility ity. . NOTE: : Los oss s of a pro rovid vider er or pro rovid vider er gro roup p is not t a qualify ifying ing even ent t to chang nge carr rrie iers. s.

Quali ualifying fying Ev Even ents ts Continued ntinued ■ If there has been a qualifying event, coverage becomes effective the day following loss of coverage, providing the enrollment is made within 31 days of the Qualifying Event . Payroll deductions must begin at the start of the pay cycle in which the Qualifying Event occurs. ■ Dropping Benefit Coverage ■ Dependents that were covered under another group plan and lose that coverage -When employees cancel due to a qualifying event may be medical/dental/vision coverage, re-enrollment immediately insured under the State plan, cannot occur until the next open/switch provided adequate proof of previous group enrollment unless there is a new Qualifying coverage is submitted to ERISA and the Event. Since Disability and Dependent/ employer. Enrollment of the dependents Supplemental Life premiums are post-tax, must be made within 31 days of the loss these coverages can be cancelled by of coverage. Proof of dependency must be employees at any time submitted before coverage will begin. ■ A qualifying event acts like an Open/Switch Enrollment for the employee, with the exception of Life coverage.

Quali ualifying fying Ev Even ents ts Cont….. ■ Employees must notify ERISA when a dependent’s eligibility ceases due to the following circumstances: Divor orce e from the emplo loyee, ee, child ld marries ies (is under er age 26 and choos oses es to to elect t cover verage age elsewhe here) e), , or ot otherwis ise e fa fails to to meet eligibilit igibility guidelin delines es. . The depen endent t must be waived ed from benef efit its. . NEVER ER delet ete e any spouse/ e/dom domes esti tic partne ner/ r/child( hild(ren ren) ) from the system. . – a. Cov overa erage e fo for depend endent ent childr dren en turn rnin ing 26 term rmin inates es at t the end of the e last t day of the e mont nth in which they turn n 26. . – b. Cov overa erage e fo for a spou ouse se becoming oming non-elig eligible ible due to divorc rce e must t be term rmina inated ed on the date e of the Divor orce Decree. ee. – c. Domes esti tic Partn tner ers s must t also lso be term rmin inated ed fro rom cov overa rage e on the e date e of term rmin ination ion of domes estic ic partner nersh ship ip. . – d. Medic ical, l, Dent ntal l and d Vision ion cov overage e fo for deceased eased empl ployees ees or dependent endents termin rminates es on the last day of the e pay period iod fo for which deductions/payments were made. The actual date of an employee’s death should be recorded, in SHARE, in the employee’s Biographical Details tab at the “Modify a Person” module. – e. If the ineligible dependent is the employee’s last or only dependent, ERISA will change the payroll coverage from family t o couple le or single. le. If there ere are e ot other er cov overed d depend endent ents, s, the e cov overage e type e and d prem emium ium may not ot change. e. – f. If a Non-POP OP emplo loyee ee chooses ses to waive e any depend endent ents fo for any reason son ot other er than ceasin sing to o meet t eligib ibilit ility requirem uirement ents, s, obtain a signed and dated form documenting the employee’s intent to cancel coverage. Coverage will terminate on the last day of the e pay period iod in which the applica lication ion is signed ned and a deducti tion on has s been taken. en.

Tra ransf nsfer ers ■ State Employees who transfer from one State agency to another State agency or covered LPB*, with no break from employment, may transfer their employee benefits coverage without the waiting period that applies to new employees. Benefits must remain the same and will be effective the first day of employment at the new agency with no break in coverage. ■ Employees who transfer must keep the same coverage(s) they previously had. They cannot add or delete coverage(s) at the time of transfer. If the employee chooses to add a benefit not previously enrolled in, they will need to be treated as a new hire, with appropriate eligibility waiting periods. ■ It is recom comme mend nded ed that t emplo loyees es only y transf sfer r at the e begi ginning nning of a p pay period iod. . ■ NOTE: : With any break in service followed by a rehire (even for 1 day), the employee is considered a new hire . – Re-Instatements are only considered with a court order and review/approval by the Employee Benefits Bureau.

Re-Instatements/Settlement Agreements Human Resource Personnel are responsible for working with their legal team along with DFA in regards to any settlement agreements granted.  Reinstat nstateme ments nts are only considered with a court order and review/approval by the Employee Benefits Bureau.  DFA Requirements for settlement Agreements can be found at the link listed below. http://www.nmdfa.state.nm.us/uploads/FileLinks/142e987c03644bda92401c7c85f0 8944/DFA_Requirements_for_Settlement_Agreements_.pdf

Job Data Entry *Job Data Change ge- Ad Additiona nal action on may be r requ quired d if the following wing occurs -Chang nge e of Date -Row is Removed

Job Data Entry

Job Data Entry Out of Sequence Event-Action Required

Job Data Entry Continued… Please ase Advise se Eris isa a Adminis inistrativ trative e Se Servi vices ces   jdillon@e lon@easi sitpa.co tpa.com Templat plate  Sub ubject ject Line: ne: Action ion Required uired- On On Dema mand nd Ev Event nt Maintenance enance Gree reeti tings: ngs: A job data entr A jo try y has been en process cessed ed for emplo mployee ee (Emplo Employee e Name) me) (Empl Empl. . ID ID#.)Th .)This s has posit itione ioned d events ents to be out ut of sequenc ence, , left t the e last event ent open en, , or left t bene nefits ts active e when en they y sh should ould be terminat minated ed. . Please e re re- process cess events ents accordingl dingly y to corre rect ct recor cord. d. Thank ank you u for your ass ssista stance nce. (Your our Signa nature ture)