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VitaFlex Employee Guide: Making & Changing Elections

How Do I Make An Election?
You must complete and make a formal election when you first become eligible under the Plan. Please check with your Human Resources Department in order to identify your Employer’s VitaFlex election process.

You must also make a formal election each Open Enrollment period for the next Plan Year (January 1st through December 31st). The Open Enrollment period is usually in late October or early November. Your Employer will educate you on the Open Enrollment process each year. If you do not submit a new election form by the scheduled Open Enrollment due date, your participation will terminate at the end of the Plan Year and your salary reductions will automatically return to zero for both the Medical and Dependent Care Reimbursement accounts for the following Plan Year. By contrast, the pre-tax premium election you make for participating in your employer’s health plans is an evergreen election and will not be terminated or changed unless you specifically request it during an annual Open Enrollment. When Can I Change My Election?
The election you make is considered irrevocable for the Plan Year and cannot be changed until the end of the Plan Year. You may change your election annually at Open Enrollment. You will receive Open Enrollment materials annually before the new Plan Year from your employer. All forms must be returned by the deadline indicated by your employer. Open enrollment elections are effective on January 1st of the following year.

There are several specific exceptions to this Irrevocability Rule. If you experience a qualified status change during the Plan Year, or if you experience one of the other special exceptions to the Irrevocability Rule, you may change your election. However, your new election must be specifically on account of and consistent with the status change that occurred. The IRS has many complex rules surrounding election changes. Please refer to your Summary Plan Description for full details. What Is A “Status Change”?
A Status Change is a material change in your personal, employment or family situation that affects your participation in or eligibility for your employee benefit plans. The IRS rules governing Status Changes are very specific and detailed and only allow certain changes. The IRS also requires that any election changes made must be consistent with the status change. This requirement means the change must be on account of and correspond to the status change. For more detailed information on Status Changes and Election Changes, please refer to your Summary Plan Description.

What Must I Do To Change My Election?
You must complete a VitaFlex Change of Election form indicating your requested election change. To be considered, your form must be received by your employer within 30 days of the Status Change or other approved change date. If approved, the change will be made as soon as administratively possible. Election changes cannot be made or applied retroactively.

What Are The Rules For Status Changes?
In order to change your Medical Reimbursement, Dependent Care Reimbursement or Premium Salary Reduction election, your change of status must fit into one of the following “Change of Status” categories defined by the IRS. Additionally, the requested change must be “consistent” with the status change. Generally, this means that your election change must be on account of and correspond to the status change. In addition, your eligibility for benefits must be affected in order to qualify. Simply having a change in benefits without an eligibility change will not generally qualify as a valid status change. Following is the list of eligible status changes:

Change in your legal marital status (marriage, divorce, death of spouse, legal separation).
Change in your number of tax dependents (birth, adoption, placement for adoption).
Change in Employment Status (any change in the employee’s or spouse’s employment that affects benefit eligibility, including termination or commencement of employment, strike, commencement or return from unpaid leave of absence, a change in worksite, or any change in employment or work schedule that affects eligibility for benefits).
Termination or commencement of employment for you, your spouse or your eligible dependents.
Change in your dependent’s eligibility (either satisfying or ceasing to satisfy eligibility requirements including attainment of age, gain/loss of student status, marriage, etc.).
Change in residence for you, your spouse, or your eligible dependents.
Commencement or termination of adoption proceedings.

What Other Reasons Qualify for Mid-Year Election Changes?
There are several other circumstances which allow for a mid-year election change. These special cases are listed below. In all cases, the election change must be consistent with the election.

Mid-Year Change in Cost or Coverage - Applies only to Dependent Care and Premium Salary Reductions, not to Medical Reimbursement. If the cost of dependent care changes, a new corresponding election may be made. However, this exception does not apply if care is provided by a relative.
HIPAA Special Enrollment Rights.
COBRA Qualifying Events.
Judgment, Decree or Court Order.
Entitlement to Medicare or Medicaid.
FMLA Leaves of Absence.