Enrollment (adding insurance, changes to insurance and/or cancelling insurance) throughout the year can be done within 31 days of a Section 125 qualified event status change. The employee must complete paperwork in the Benefits Office within 31 days of the qualified event. For example, if you have a baby on July 1st, you must complete paperwork before close of business on July 31st.  A phone call, telephone message or email notification is not enrollment in the plan. 
If the 31st day is on a non-working day, you need to complete paperwork on a working day prior to the deadline.

A qualified status change may be any of the following:

Birth or adoption of a child

• It is not necessary to wait for the Social Security number to enroll your newborn; however, the Benefits Office will need this information as soon as it is available.
• Please provide the Benefits Office with a copy of the Verification of Birth Facts (from the hospital).
• TRS-ActiveCare automatically provides health coverage for a newborn child of a covered employee for the first 31 days after the date of birth, but this coverage ends unless the newborn is added to the employee’s health coverage within the deadline.
• For the newborn, the effective date of coverage will be the newborn’s date of birth (as long as paperwork is completed in the Benefits Office within the 31 day deadline).
• If you add your baby and self onto a new plan other than MISD, you have 31 days from the effective date of new coverage to cancel your MISD insurance (change is effective 1^st of the month following date completed paperwork is received in the Benefits Office within the 31 day deadline).
   

Marriage

• It is not necessary to wait for your marriage license to enroll in insurance; however, the Benefits Office will need a copy as soon as it is available.

• The effective date of coverage will be the first of the following month after the marriage date (as long as paperwork is completed in the Benefits Office within the 31 day deadline).

• If you obtain new coverage on your spouse’s plan, you have 31 days from the effective date of new coverage to cancel your MISD insurance (change is effective 1^st of the month following date completed paperwork is received in the Benefits Office within the 31 day deadline).
   

Divorce
(if the divorce results in a loss of other coverage)

• You may enroll in the MISD insurance within 31 days of involuntary loss of coverage due to a divorce.
• Please provide the Benefits Office with a copy of the Certificate of Coverage or Letter of Eligibility that shows each plan participant that lost insurance coverage, the effective and end date of coverage.  The effective date of coverage will be the first of the following month after the loss of coverage date (as long as paperwork is completed in the Benefits Office within the 31 day deadline).
   

A court orders the employee to provide health coverage for an eligible child

• If Mesquite ISD receives a National Medical Support Notice (NMSN) from the Attorney General’s Office, it is mandatory that we enroll your court-ordered dependent in a health plan.  If your court-ordered dependent is not already enrolled in a health plan, that child will be added to the existing health plan that employee is already enrolled in.  If employee is not enrolled in health insurance, employee will have opportunity to enroll in a health plan.  If no election is made, employer reserves the right to enroll employee + child in least expensive health plan available.
• Effective date of coverage is date that NMSN is received in MISD Benefits Office.
• Health insurance may not be cancelled and/or terminated without a release form from the Attorney General’s office.
  • The termination of National Medical Support Notice document only serves as notice that the employee no longer has a judicially or administratively ordered obligation to provide coverage for the child(ren) in accordance with a previous support order for the listed child(ren).
  • If you receive a termination notice for the court-order and the child(ren) has obtained new coverage within 31 days, you may cancel the coverage by completing paperwork in the Benefits Office within 31 days of new coverage effective date. Health insurance is not retro-terminated; change is effective first of month following date completed paperwork is received in the Benefits Office.

Death of spouse or dependent

The employee or eligible dependent involuntarily loses other coverage

Please provide the Benefits Office with a copy of the Certificate of Coverage or Letter of Eligibility that shows each plan participant that lost coverage, the effective and end date of coverage.  The effective date of coverage will be the first of the following month after the loss of coverage date (as long as paperwork is completed in the Benefits Office within the 31 day deadline).

The employee and/or dependent(s) obtains coverage elsewhere

You may cancel insurance within 31 days of obtaining new coverage elsewhere. The effective date will be the first of the month following the date paperwork is completed in the Benefits Office(as long as paperwork is completed in the Benefits Office within the 31 day deadline). Please provide a copy of enrollment paperwork with effective date of new coverage.

Change in dependent status

• If a dependent ceases to meet eligibility status for one of the plans, you have 31 days to cancel them from the plan.  Please see benefit summaries and/or plan descriptions for dependent eligibility requirements.

• The dependent’s insurance will terminate at the end of the month following the month that eligibility ceases; however, the premium will terminate on the first of the month following the date paperwork is completed in the Benefits Office.

I'm Turning 26 Flyer​​​​​​If you experience one of the above changes, you will need to complete paperwork at the Benefits Office within 31 days of the event.

You will be required to submit documentation and proof to substantiate your request; however, that may be submitted at a later date (within a reasonable time-frame) if you do not have the documentation at the time you complete the paperwork in the Benefits Office. Your 31 day deadline for completion of paperwork must be met! Benefits will be unable to process your enrollment or cancellation request without the documentation.

The following reasons do not qualify as special enrollment events: 

• voluntary termination of coverage such as spouse’s annual enrollment or failure to pay premium

• any additional surcharge or benefit reduction for spouse coverage

• an increase in the premium cost

• a reduction in the employer’s contribution to the premium

• any reduction in benefits; or a doctor/provider no longer participates in the plan’s network.