This is the time for you to make important decisions about your benefits. You can choose new plans, add or drop dependents, or even sign up for a flexible spending account (FSA). Spending time now to review your plans and make careful, informed choices can help you get the most from your benefits.
All new or newly eligible associates have 30 days from their initial benefits eligibility date to enroll or waive their benefits online.
Your benefits begin the first of the month following or coinciding with your hire or status change date. This is your waiting period. For example, if your first day of employment is Feb. 3, your benefits begin March 1. If your first day of employment is Feb. 1, your benefits begin Feb. 1. Your benefits remain in effect until Dec. 31 of each year and you may not make a change mid-year unless you have a qualified life event.
Sabrina started at Nemours Children’s on Feb. 1. A couple of days later (on Feb. 3), Sabrina went to see her doctor, but Sabrina hadn’t completed enrollment until her 15th day on the job. (Things were very busy in Sabrina’s department.)
Once Sabrina’s enrollment in a medical plan was complete, it retroactively went into effect from her first day on the job, and she was able to submit a claim to her new coverage provider for her Feb. 3 doctor visit. (The “effective date” of her new coverage was her start date, Feb. 1.)
If Sabrina had also seen the doctor sometime in January, before her Feb. 1 start date, that visit would NOT be covered by her new medical plan, as Sabrina’s coverage was not yet effective.
Annual Enrollment Period
Each year, Nemours Children’s Health hosts an Annual Enrollment period. The period for annual enrollment usually begins mid-fall (October/November) and is available for three to four weeks. This is your opportunity to review your benefits, to make changes or confirm your current benefits are right for you and your family. After the Annual Enrollment period closes, you will NOT have an opportunity to adjust your benefits until the next Annual Enrollment period UNLESS you have a status change or qualified life event during the year.
Status Changes and Qualified Life Events
If you experience a change in status, or a qualified life event (QLE), you may be able to make changes to your benefits elections mid-year. Examples of QLEs include marriage, divorce, birth of a child, adoption, loss of coverage and some other specific events. You have 60 days from the date of the event to make changes online. Log on to NemoursBenefits.com, and go to “My Profile” or click on “My Benefits” to start a Life Event change. Some events — like marriage, divorce, loss of coverage — may be initiated in advance of the event date. You will be required to upload supporting documentation for all events. Any changes will be pended until the submitted documentation can be reviewed and approved. Once approved, benefits will begin on the first of the month following your election.
Sabrina had a baby boy. After a few long days (and nights), she logged on to NemoursBenefits.com and declared the birth event. She then went through and chose the benefits he needed, based on a pediatrician’s recommendations. She knew her son’s needs would change over time and she can opt to add coverages during the Annual Enrollment period for future plan years.