Yes, an employer can require you to not change your health insurance coverage unless it’s during the open enrollment period. That includes adding and removing dependents to your health plan. The one exception is if you have a qualifying event that creates a special enrollment period.
Once you make your health insurance choices during your annual open enrollment period at work — including naming the dependents for the plan — they’re locked in until the following year’s open enrollment period. The exception is if you experience a qualifying life event.
Major life events that will allow you to “redo” your job-based health insurance plan and make certain benefit changes typically include:
- Marriage.
- Divorce or legal separation.
- Gain a child through birth or adoption.
- Loss of a child’s eligibility (reaches the maximum age for coverage).
- Death of dependent (spouse or child).
- Loss or gain of health coverage due to a change in employment status for you, spouse or dependent.
- Relocation by you or a dependent to an area outside of the health plan service area.
After an eligible life event, the window to make changes to a job-based health plan is short, usually just 30 or 31 days. If you don’t act promptly to make changes, you indeed have to wait until the next annual enrollment period.
Let’s look at an example. Say your daughter got health insurance through a full-time job. She’s on your health coverage and removing her from the plan would save you more than $200 a month.
You can typically remove your daughter from health coverage if she just got health insurance and you make the change within a special enrollment period. Getting new coverage starts a special enrollment period. However, if you miss the special enrollment period, you’ll have to keep your daughter on your health plan until the open enrollment period.
Another instance that would start a special enrollment period is when your child, who is on your health coverage, turns 26. The Affordable Care Act allows parents to keep children on their health plans until 26. Once they turn 26, they have to find other coverage. For instance, they could enroll in an employer’s plan, an Affordable Care Act marketplace plan or get added to a spouse’s health insurance plan.
If you’re not able to remove your daughter, she will have double coverage. Having two health plans means two premiums but can also result in lower out-of-pocket costs when she needs care. Read more about primary vs. secondary coverage when you have two health plans to learn how your daughter’s health plans will work in conjunction with each other until you can remove her from your policy.
