Risk and Benefits Management

831 Simpson Rd. STE 100; Kissimmee, FL 34744

Phone: 407-870-4899 / Fax: 407-943-7749

Ken F. DeBord

Director of Risk and Benefits Management

How To Make Plan Changes During The Year
  • Section 125 and Benefit Election Changes 
  • Under Section 125 of the Internal Revenue Service (IRS) code, you are allowed to pay for certain group insurance premiums using pretax dollars. This means your premium deductions are taken before federal income and Social Security taxes are calculated. Depending on your tax bracket, your savings could be significant.
    However, you must make your benefit elections carefully, including the choice to waive coverage, because IRS regulations state that your pretax elections will remain in effect until the next annual open enrollment period, unless you experience an IRS-approved qualifying change in status. Qualifying change-in-status events include, but are not limited to:

    • Marriage, divorce, or legal separation*
    • Death of spouse or other dependent
    • Birth or adoption of a child
    • A spouse’s employment begins or ends (must have coverage from previous employer)
    • A dependent’s eligibility status changes due to age, student status, marital status, or employment
    • You or your spouse experience a change in work hours that affect benefits eligibility
    • You relocate into or outside of your plan’s service area
    • Voluntary or involuntary loss of other qualifying coverage or gaining other group coverage
    • Your eligible child(ren) lose coverage under a federal or state-sponsored health program like Florida KidCare
    *   Legal separation is not recognized in Florida.

    Please note that your qualified status change must be consistent with the event. For example, if you get married, you can add your spouse to your current medical coverage, but you cannot switch medical plans. You must notify Risk and Benefits Management within 30 days of your qualified status change.

    Effective Date Following a Qualifying Event
    Your benefits effective date following a qualified status change is the first month after paperwork is received and online enrollment is completed.  Birth or adoption of a child will be effective the date of birth or date of placement for adoption.

    Adding Newborn(s) or Adopted Child(ren)
    In accordance with Florida Statute 627.6575 Coverage for newborn children, children added on after birth or adoption will have 30-days coverage without an additional premium.  However, the plan co-insurance and deductibles still apply.

  • If a child is not enrolled within thirty-one (31) days from the date of birth, but is enrolled within 60 days from the date of birth by written notification, coverage for the newborn child will become effective from the date of birth. Any premiums due must be paid retroactive to the date of birth for coverage to be effective.

What to do in case of a Qualifying Event

Contact the Risk and Benefits Management office within 30-days of the qualifying event with paperwork that includes the date of the event and information (date of birth) of you and/or your dependents experiencing the event.  Once the correct paperwork is received by the 30-day deadline, the Benefits Enrollment System will be open for one day to make your changes. 

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