Human Resources: Benefits Homepage

Effective Date Rules for Health Insurance Changes (basic) 4-28-04

Event	Proofs Required	Effective Date Rule
New employee, or newly eligible employee	Social Security Cards Marriage/Birth Certificates	Determined by date of request If the request is made within the 42 day waiting period (56 for PEF employees) effective date is 42 days from the date of hire. Suggested employee complete forms at least 30 days after date of eligibility. *If request made after 42 (56) days the effective date is the first day of the fifth payroll period following the date of request.
Coverage through another source terminated – request enrollment through Brockport	Need proof of termination of other coverage (can be letter from spouse's employer, carrier, etc.)	Determined by date of request If the request is made within the 42 day waiting period (56 for PEF employees) effective date is 42 days from the date of hire. Suggested employee complete forms at least 30 days after date of eligibility. *If request made after 42 (56) days the effective date is the first day of the fifth payroll period following the date of request.
Cancel coverage while on a leave without pay	None	Determined by date of event *Equals the effective date of the leave without pay
Voluntary cancellation	May only be done if gaining insurance through another source. Proof required (with effective date)	Determined by date of request *If not within 28 days must wait until open enrollment
Change to single coverage due to all dependents becoming ineligible/OR deleting a dependent (death, age, divorce)	Proof of age, death, divorce required.	Determined by date of event *Day of event
Child over age 19 Graduates College	Proof of graduation needed	Determined by date of event *3 months after month of graduation dependent is termed off of insurance

*Note: COBRA (continuation of coverage at full share) information is automatically sent to employees or their dependents whenever coverage is lost. Cost and procedural information is sent in this mailing by the Employee Benefits Division in Albany.