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Benefits » Life & Work Changes » Appointment/Status Change

Dependent Loss of Eligibility

Whenever a family member loses eligibility to participate in LANS-sponsored plans, it is your responsibility to de-enroll that family member within 31 days of the event.

Step 1 Contact the Lab's Benefits Office at 505-667-1806 for assistance. Otherwise, you are liable for any excess LANS costs and for any plan expenses incurred by the ineligible family member(s). Family members lose eligibility for the following reasons:
  • For your spouse, eligibility stops on the last day of the month in which a divorce, legal separation or annulment is final.
  • For your child(ren) or grandchild(ren), eligibility for medical coverage stops at the end of the month in which the child reaches age 23 (unless eligible to continue coverage because of disability) or age 18 for legal wards or when the child marries or no longer meets all eligibility requirements to participate in LANS-sponsored benefit plans.

    Children and grandchildren can stay with your dental and vision coverage until the month they turn 25. A notice of loss of eligibility, along with the instructions and COBRA paperwork (described below).
  • For your adult dependent relative, eligibility stops at the end of the month in which your family member no longer meets all eligibility requirements to participate in LANS-sponsored plans or on the day your adult dependent relative becomes entitled to Medicare (the first day of the month in which he or she becomes age 65 or the first day of the prior month if the birthday is on the first day of the month). No new adult dependent relatives can be enrolled after January 1, 2004.
  • For your same-sex domestic partner and/or partner's child or grandchild, eligibility stops at the end of the month in which the same-sex domestic partnership ends or your family member no longer meets all eligibility requirements to participate in LANS-sponsored plans.
You are also required to de-enroll a deceased family member. Contact the Lab's Benefits Office for assistance.

De-enrolling a family member who is no longer eligible to participate in LANS-sponsored benefit plans does not in itself create a new period of initial eligibility (PIE). However, if accompanied by an involuntary loss of other group insurance coverage or by a move out of or a return to a plan service area, you or your family member may be eligible for a new PIE for some benefit plans.
Step 2 COBRA Continuation
If you or any family member(s) lose eligibility for LANS-sponsored medical, dental, and/or vision coverage, you may be able to continue group coverage through the Consolidated Omnibus Reconciliation Act of 1985 (COBRA), as amended.
Step 3 Health Care Reimbursement Account Continuation
If you are enrolled in the Health Care Reimbursement Account (HCRA) and leave LANS employment during the plan year, you can continue your participation through the end of the current plan year (December 31) by making after-tax payments to your account. The plan administrator will send you a "Qualifying Event Notice" which explains the procedure for continuing your participation under COBRA.

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