AETNA PPO PLAN - My Benefits Portfolio - Trinity Health
AETNA PPO PLAN - My Benefits Portfolio - Trinity Health
AETNA PPO PLAN - My Benefits Portfolio - Trinity Health
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COBRA continuation coverage under another plan, you and/or your eligible Dependents must exhaust the<br />
COBRA coverage before you and/or your eligible Dependents may enroll in this Plan under a special<br />
enrollment period.<br />
If you timely enroll, coverage under the Plan for you and/or your eligible Dependents will be effective on<br />
the date the other coverage is terminated. If you do not timely enroll, enrollment for yourself and/or your<br />
new eligible Dependent(s) must wait until the next Annual Open Enrollment period, to be effective at the<br />
beginning of the next Plan Year (unless another event occurs which would allow you to enroll yourself<br />
and/or your new eligible Dependent(s) prior to such time).<br />
If you acquire a new eligible Dependent as a result of marriage, birth, adoption, or placement for<br />
adoption, you will be entitled to special enrollment in the Plan if you meet one of the following conditions:<br />
● Non-Enrolled Associate: If you are an eligible Associate but have not enrolled in the Plan, you may<br />
enroll upon your marriage, or upon the birth, adoption, or placement for adoption of your child.<br />
● Non-Enrolled Spouse: If you are an eligible Associate who is already enrolled in the Plan, you may<br />
enroll your spouse at the time of his or her marriage to you. You may also enroll your spouse if you<br />
acquire a child through birth, adoption, or placement for adoption.<br />
● New Dependents of an Enrolled Associate: If you are an eligible Associate who is already enrolled<br />
in the Plan, you may enroll a child who becomes your eligible Dependent as a result of marriage,<br />
birth, adoption, or placement for adoption.<br />
● New Dependents/Spouse of a Non-Enrolled Associate: If you are an eligible Associate but you are<br />
not enrolled in the Plan, you may enroll a spouse or child, as applicable, who becomes your eligible<br />
Dependent as a result of marriage, birth, adoption, or placement for adoption. However, you (the nonenrolled<br />
Associate) must also be eligible to enroll in the Plan, and actually enroll in the Plan at the<br />
same time.<br />
You must enroll yourself and/or your new eligible Dependent(s) no later than 30 days after the date of the<br />
event that entitles you and/or your eligible Dependent(s) to the special enrollment period. Coverage will<br />
become effective as of the date of the event. If you do not timely enroll, enrollment for yourself and/or<br />
your new eligible Dependent(s) must wait until the next Annual Open Enrollment period, to be effective at<br />
the beginning of the next Plan Year (unless another event occurs which would allow you to enroll yourself<br />
and/or your new eligible Dependent(s) prior to such time).<br />
In addition to the above, under the Children’s <strong>Health</strong> Insurance Program Reauthorization Act of 2009, you<br />
may enroll yourself and/or your eligible Dependent in the Plan if (1) you and/or your eligible Dependent<br />
lose Medicaid or Children’s <strong>Health</strong> Insurance Program (“CHIP”) coverage due to no longer being eligible<br />
for those benefits, or (2) you and/or your eligible Dependent become eligible for premium assistance in<br />
the Plan under a Medicaid program or CHIP. You must enroll in the Plan due to one of these reasons no<br />
later than 60 days after the date of the event that entitles you and/or your eligible Dependent to the<br />
special enrollment period. If you enroll within 60 days after the date of the event, coverage will become<br />
effective as of the date of the event. If you do not timely enroll, enrollment for you and/or your eligible<br />
Dependent must wait until the next Annual Open Enrollment period, to be effective at the beginning of the<br />
next Plan Year (unless another event occurs which would allow you to enroll yourself and/or your new<br />
eligible Dependent prior to such time).<br />
CHANGE IN STATUS<br />
The benefit choices you make are in effect for one entire Plan Year and generally may be changed only<br />
during the Annual Open Enrollment period. Elections you make during Annual Open Enrollment are<br />
effective beginning January 1 of the following Plan Year. The exception to this rule prohibiting election<br />
changes during a Plan Year is the occurrence of a special enrollment event described above or a<br />
qualified change in status event described in this section. Qualified change in status events include the<br />
following:<br />
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