CHCGA - Coventry Health Care of Georgia

CHANGES DURING A PLAN YEARThe decisions you make now for next year’s benefits will remain in effect throughDecember 31, 2007. Under federal law, your selections for any benefits that youpay for with pre-tax dollars go into effect on every January 1 and remain for thefull plan year unless you experience a qualified change in family status. Theseinclude:• Marriage or divorce• Death of spouse or child, or loss of an eligible dependent for any reason• Birth, adoption, or legal change of custody• You or your eligible dependents lose or gain medical coverage under yourspouse’s group plan• Loss of eligible dependent status or status change• Change from FT to PT, PT to FT, PRN to FT, PRN to PT, or FT to PRNYou must notify your Human Resources Department within 31 days of a QualifiedFamily Status Change (QFSC), along with written documentation of theQFSC; otherwise, you will have to wait until the next annual openenrollment period. A change in the status may result in a change in the premiumlevel. It is the responsibility of the member to change their coverage levelby using the Enrollment /Change Form within 31 days of the QFSC.5