Case Studies
Enhancing Employee Benefits While Saving $312K Annually
Company X, an IT services company based in Northern California, employs 150 professionals dedicated to delivering cutting-edge technology solutions. Despite their focus on innovation and employee well-being
Streamlining Benefits Enrollment for a Large Medical Practice
J Associates is a large medical practice located in the East Bay, employing 60 healthcare professionals dedicated to providing exceptional medical care. As a growing organization
Maximizing Savings with Level-Funded Plans for a Bay Area Employer
S Inc. is a dynamic company based in San Jose, CA, employing over 150 professionals. Known for its innovative approach and young workforce, S Inc. had been providing its employees with fully insured health plans
Question of the week
Does a spouse’s open enrollment enable an employee to change their benefit elections midyear?
Yes, if your cafeteria plan document allows it. A spouse’s open enrollment period could allow an employee to make a corresponding midyear election change under IRS § 125.
For example, an employee’s spouse could decline or drop coverage under their own plan and be added to the employee’s plan. Alternatively, the employee could drop coverage under the employee’s plan and enroll in the spouse’s plan. The employee-requested change must correspond with the election made under the spouse’s plan.
This generally applies to medical, dental, or vision coverage changes. It doesn’t allow the employee to change unrelated benefits, such as life insurance, disability coverage, or a health flexible spending account (HFSA) election.
If one of your employees wants to make a change, double check that your cafeteria plan includes the applicable midyear election change provision. If it does, have the employee provide documentation of the spouse’s open enrollment period and any election change made with respect to the spouse’s coverage.
