Qualifying Life Events Qualifying events are events that cause an individual to lose his or her group health coverage. The type of qualifying event determines who the qualified beneficiaries are for that event and the period of time that a plan must offer continuation coverage.
Qualifying events include: • Marriage
• Divorce or legal separation • Birth or adoption of a child • Death of spouse or dependent child • Change in employment status • Loss of other coverage • Entitlement to Medicare or Medicaid • Child turning 26 years old
Information Needed for Enrollment
All Eligibility As a Horizons Diagnostics employee, you may be eligible for enrollment in a variety of insurance products. You may enroll your eligible dependents for coverage once you are eligible. Your eligible dependents include: • Your legal spouse • Your children up to age 26 (as identified in the plan document).
In preparation of your enrollment, please have the following information readily available for you and your dependent(s):
• Date(s) of birth
• Social Security Number(s): Mandatory
• Full name, relationship, and Social Security Number(s) for Life Beneficiary(ies). (Beneficiaries must be at least 18 years old or you will be required to name a guardian for him/her.)
Once your elections are effective, they will remain in effect through the plan year. You may only change coverage within 30 days of a qualifying life event.
You must notify Human Resources within 30 days of the qualifying life event. Depending on the type of event, you may be asked to provide proof of the event. If you do not contact Human Resources within 30 days of the qualifying event, you will have to wait until the next annual enrollment period to make changes.
3 Horizons Diagnostics, LLC. 2022 Enrollment Guide
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