NY44 Health Plan Notice of Special Enrollment Rights

NY44 Health Plan Notice of Special Enrollment Rights

If  you  decline   enrollment  for  yourself or dependents (including your spouse or registered domestic partner*) when  you  first  become  eligible  for  the   NY44  Health    Plan because  you  have  other   health  insurance  or  group    health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or they subsequently lose eligibility for the other coverage (or if the employer stops contributing towards the other coverage).  However, you must request enrollment in NY44 within 30 days after the other coverage terminates (or after the employer stops contributing towards the other coverage) in order to take advantage of this special enrollment opportunity.  If you miss this special enrollment date, you will have to wait until the plan’s next open enrollment period to obtain coverage under NY44.

If you acquire a new dependent as a result of marriage, assumption of a registered domestic partnership*, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents in the NY44 Health Plan during a special enrollment period.  However, you must request enrollment within 30 days after the marriage, assumption of a registered domestic partnership, birth, adoption, or placement for adoption, or you will be required to wait to enroll until the plan’s next open enrollment period to obtain NY44 coverage. 

 

Please note:  Changes to the original Application Form must be made through the Enrollment System by the District’s Benefit Clerk.  To request special enrollment or obtain more information, contact the Benefit Administrator at the school.

 *check with your employer on eligibilty