Life is unpredictable and what you plan on is not necessarily what ends up happening. Your health insurance should allow you to prepare for the unexpected and be flexible enough to change with you over the years.
Flexibility is one of the hallmarks of CaliforniaChoice. We make it easy for you and your employees to update your health insurance coverage when you experience a big life change or what is referred to as a “life event.”
What Is a Qualifying Event for Employee Sponsored Health Insurance?
There are many life events that can trigger eligibility to make a change to coverage, including:
- Marriage or domestic partnership: A change in your or an employee’s marital status (e.g., marriage, divorce, or separation) or domestic partnership.
- New family member: Adding a dependent child through adoption or birth.
- Late enrollment or involuntary loss of coverage: If an employee waived coverage before, he/she/they can enroll late and/or change benefits. This can occur when that other coverage ends due to death of the spouse (who maintained it). Or if there is a loss of benefits eligibility due to reduced work hours or job loss.
- Remove coverage or dependents: A covered employee can remove existing insurance or dependents from enrolled coverage. For example, when a dependent child reaches age 26.
- Moving: If an employee moves to a new place of residence (and out of his/her/their existing health plan’s service area).
The Timeframe for Making Changes
Employees generally have 60 days from a qualifying/triggering event to make coverage changes. Login at calchoice.com for specifics about how to make different kinds of changes. Or direct your employees to call 800.558.8003 or 714.558.8000, or send an email to CustomerService@calchoice.com.
If an employee wants to add coverage for a newborn or newly adopted child or remove a dependent from coverage, the process is similar: login at calchoice.com or contact Customer Service.
Effective Date of Changes
Changes requested will be effective on the first day of the month following receipt by CalChoice of a completed request. For example, if an employee submits a request/application on May 10, the change would be effective June 1. (If the employee submits a request through you, it’s important you forward it as soon as possible, so as not to delay the effective date of the change.)
If the request is for new ID Cards, they will be sent within 7-10 business days after processing is complete.
Help When It’s Needed
We make it easy for you and your employees to make changes, which is just one reason to love CaliforniaChoice. Another, of course, is the availability of 130+ coverage options from eight health plans. With CaliforniaChoice, you and your employees have access to more doctors, specialists, and hospitals than any other single employer-sponsored program available in California.
Talk with your employee benefits broker today. Or, if you don’t have a broker, we can help you find one.