Insurance changes for employees

Insurance changes for employees

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Insurance changes

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The IRS allows employers to make changes to an employee's benefit plan only during open enrollment OR if the employee experiences what the IRS calls a "qualifying event."  Open enrollment for Macomb County employees is in the fall, and takes effect January 1 of the following year. Qualifying Events as defined by the IRS include: 

  • Adoption or assuming guardianship of a qualified dependent
  • Birth
  • Death
  • Divorce
  • Leaving County employment**
  • Loss of coverage from another source
  • Marriage

Active employees who experience qualifying events only have 30 days to make these changes, so don’t delay. If the qualifying event happened more than 30 days prior, you will have to wait until the annual open enrollment period to make changes.

**Individuals whose employment with the County is ending prior to retirement have 60 days to elect coverage through COBRA.

Please note, submission of documentation does not constitute an official change until it is approved by Human Resources and Labor Relations

With the exception of individuals leaving County employment, these changes can be made through the Employee Navigator portal. Before you visit the Employee Navigator portal, please select the event that applies to you from the options below. You will see a list of the documents required in order to complete your changes, as well as some other things to consider. If you need information about how to elect benefits when you leave County employment prior to retirement, please select “I am leaving County employment” from the menu below.

Please select the life event that applies to you from the list below:

Documents you will need to add to Employee Navigator:

  • Court order indicating requirements to maintain health care coverage (medical, dental and vision)

Other things to consider:

Documents you will need to upload to Employee Navigator:

  • Birth certificate or Hospital Verification Record

IMPORTANT NOTICE: Certified birth certificates can take several weeks to arrive, and you only have 30 days from the date of your baby’s birth to add your baby to your plan. Do NOT wait for the certified birth certificate before you contact us. Your baby can be added to your health care plan if you provide us with the Hospital Birth Verification document. Once you have your child’s social security card, you must submit that as well.

Other things to consider:

Document(s) you will need to upload into Employee Navigator:

  • Copy of death certificate

Other things to consider:

Document(s) you will need to upload to Employee Navigator:

  • Copy of your divorce decree (in whole)

IMPORTANT NOTICE: Employees who fail to notify the County about their divorce within 30 days of the date it is finalized are required to reimburse the County for premiums or services rendered on behalf of the ex-spouse after their eligibility expired.

Other things to consider:

Document(s) you will need to upload to Employee Navigator:

  • Documentation of the loss of coverage

If you need to add a spouse or dependents to your coverage, you will need the following:

  • Marriage license
  • First page of your most recent 1040 Tax Return
  • Birth certificates for your child/stepchild
  • If you have guardianship over a qualified dependent, a court order indicating requirements to maintain health care coverage (medical, dental and vision)

If your employment with the County is ending, you should know the Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time, and under certain circumstances. These include voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce and other life events. Qualified individuals are required to pay 100 percent of the premiums, plus 2 percent for administrative costs. For more information about your rights under COBRA, please visit the U.S. Department of Labor - COBRA Please note:

  • Enrolling in COBRA cannot be done in Employee Navigator.
  • If your employment with the County has ended, you will receive a notice regarding benefits that are available to you, as well as the premiums associated with those benefits, within 30 days. If you do not receive your notice within 30 business days, please contact us at 586-469-5650.
  • Instructions on how to enroll in COBRA will be included in the notice.
  • You have 60 days to opt into a COBRA plan.

Document(s) you will need to upload to Employee Navigator:

  • Marriage license

If you will be adding step-children to your plan, you will need the following:

  • Birth certificates for your child/stepchild

Other things to consider:

I already have an Employee Navigator account

I need to create an Employee Navigator account

Need help using Employee Navigator? Review this handy guide for information on how to enroll in Employee Navigator, and submit qualifying life events for processing.