Contacts & Resources

Life Events

Generally, the benefit elections you make when first eligible or during Annual Enrollment will be in effect for the entire calendar year. Mid-year changes are not allowed unless you experience a qualified life event that affects your coverage needs and take action in ADP within 30 days.

Qualified Life Events

You may make changes to your elections during the plan year only if you experience a qualified life event, such as:

  • Birth
  • Adoption
  • Marriage
  • Divorce
  • Loss of other coverage by your spouse/domestic partner
  • Covered dependent child reaches age 26

If you have a qualifying life event, you must update your elections in ADP at workforcenow.adp.com and provide the required documentation within 30 days of the event. If you don’t, you must wait until the next Annual Enrollment period to make any changes to your current benefit plan.

Any new benefit elections must align with the specific qualified event. For example, getting married qualifies you to add your new spouse to existing medical coverage, but not to change from one medical plan option to the other. Similarly, if you have Employee + Child medical coverage and your child reaches age 26, you may switch to Employee Only coverage but not increase your Employee-Paid Supplemental Life coverage. See the chart below for more information on benefit changes generally allowed for specific life events.

When Benefit Changes Will Take Effect

  • If you make a new benefit election and provide the required documentation within 30 days of a qualified event, the benefit change will take effect as of the event date.
  • If you don’t act within 30 days, you will need to wait until the next Annual Enrollment period.
 

Dependent Changes

To add a spouse/domestic partner or dependent child other than a newborn, you are required to provide the dependent’s Social Security number.

If a dependent’s eligibility status changes and they no longer meet the definition of an eligible dependent, they must be removed from coverage. You must notify the VillageMD Benefits Team within 30 days by email at benefits@villagemd.com, so that COBRA (if applicable) and/or State Continuation coverage can be extended to the eligible dependent. Otherwise, your dependent may lose their right to COBRA (if applicable) and/or State Continuation coverage.

 

Is Your Medicare Eligibility Approaching?

If you and/or your covered dependents become eligible for Medicare now or during the coming year, please alert the VillageMD Benefits Team immediately by email at benefits@villagemd.com. Group health plans must follow federal Medicare coordination of benefits (COB) rules. VillageMD medical and prescription drug plans pay first (primary), and Medicare pays next (secondary).

 

Benefit Changes Based on Life Event

The following list of life events is not all-inclusive. For details about benefit changes allowed for a specific life event, including entering into or ending a domestic partner relationship, contact the VillageMD Benefits Team by email benefits@villagemd.com.

Life Event

Benefit Changes That May Be Allowed

 

Getting Married

Medical, Dental, Vision

  • Add your spouse/domestic partner to your current coverage

  • Drop VillageMD coverage to enroll in your spouse/partner’s plan

  • Add/drop dependent child coverage

Health Care FSA

  • Enroll or increase your contribution

  • Decrease your contribution if you or your eligible dependents become eligible under your spouse/partner’s health plan
    NOTE: No change to your Health Care FSA is allowed when gaining a domestic partner.

Dependent Care FSA

  • Enroll or increase your contribution

  • Decrease your contribution if your spouse/partner is not employed

  • Increase/decrease your contribution if your spouse/partner makes a Dependent Care FSA election under his or her plan

Life and AD&D

  • Make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Getting Divorced

Medical, Dental, Vision

  • Enroll in coverage

  • Drop your former spouse from your coverage

  • Add dependent child coverage if coverage is lost under your former spouse’s plan
    NOTE: Your former spouse or your children may be eligible for COBRA continuation coverage.

Health Care FSA

  • Decrease your contribution

  • Enroll or increase your contribution if coverage is lost under your former spouse’s plan

Dependent Care FSA

  • Enroll or increase your contribution to accommodate newly eligible dependents

  • Drop coverage if dependent eligibility is lost

Life and AD&D

  • Enroll in or make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Having a Baby or Adopting a Child

Medical, Dental, Vision

Health Care FSA

  • Enroll or increase your contribution

  • Decrease your contribution if you or your eligible dependents become eligible under your spouse/partner’s health plan

Dependent Care FSA

  • Enroll or increase your contribution

Life and AD&D

  • Enroll in or make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Death of a Dependent

Medical, Dental, Vision

  • Remove your dependent from your current coverage

  • Enroll if you lost coverage under your deceased spouse/partner’s plan

Health Care FSA

  • Decrease your contribution

  • Enroll or increase your contribution if you lost coverage under your deceased spouse/partner’s plan

Dependent Care FSA

  • Enroll or increase your contribution to accommodate newly eligible dependents

  • End coverage if eligible dependent dies

Life and AD&D

  • Enroll in or make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Leaving VillageMD

Most VillageMD benefit coverages end on the last day of the month in which your employment ends. You may be eligible to continue your VillageMD group health coverage under COBRA. Company-paid Basic Life, AD&D and LTD coverage ends on the date your employment ends.

Any Employee-Paid Supplemental Life, Supplemental AD&D or LTD coverage ends on the date your employment ends. Team members will have the option to port and convert their coverage.

Getting Married

Required Documents: Marriage Certificate

Medical, Dental, Vision

  • Add your spouse/domestic partner to your current coverage
  • Drop VillageMD coverage to enroll in your spouse/partner’s plan
  • Add/drop dependent child coverage

Health Care FSA

  • Enroll or increase your contribution
  • Decrease your contribution if you or your eligible dependents become eligible under your spouse/partner’s health plan
    NOTE: No change to your Health Care FSA is allowed when gaining a domestic partner.

Dependent Care FSA

  • Enroll or increase your contribution
  • Decrease your contribution if your spouse/partner is not employed
  • Increase/decrease your contribution if your spouse/partner makes a Dependent Care FSA election under his or her plan

Life and AD&D

  • Make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Getting Divorced

Required Documents: Divorce Decree

Medical, Dental, Vision

  • Enroll in coverage

  • Drop your former spouse from your coverage

  • Add dependent child coverage if coverage is lost under your former spouse’s plan
    NOTE: Your former spouse or your children may be eligible for COBRA continuation coverage.

Health Care FSA

  • Decrease your contribution

  • Enroll or increase your contribution if coverage is lost under your former spouse’s plan

Dependent Care FSA

  • Enroll or increase your contribution to accommodate newly eligible dependents

  • Drop coverage if dependent eligibility is lost

Life and AD&D

  • Enroll in or make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Having a Baby or Adopting a Child

Required Documents: Birth Certificate

Medical, Dental, Vision

Health Care FSA

  • Enroll or increase your contribution

  • Decrease your contribution if you or your eligible dependents become eligible under your spouse/partner’s health plan

Dependent Care FSA

  • Enroll or increase your contribution

Life and AD&D

  • Enroll in or make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Death of a Dependent

Medical, Dental, Vision

  • Remove your dependent from your current coverage

  • Enroll if you lost coverage under your deceased spouse/partner’s plan

Health Care FSA

  • Decrease your contribution

  • Enroll or increase your contribution if you lost coverage under your deceased spouse/partner’s plan

Dependent Care FSA

  • Enroll or increase your contribution to accommodate newly eligible dependents

  • End coverage if eligible dependent dies

Life and AD&D

  • Enroll in or make changes to Employee-Paid Supplemental Life and AD&D (evidence of insurability may be required)

Leaving VillageMD

Required Documents: Cobra election forms OR Termination letter from employer

Most VillageMD benefit coverages end on the last day of the month in which your employment ends. You may be eligible to continue your VillageMD group health coverage under COBRA. Company-paid Basic Life, AD&D and LTD coverage ends on the date your employment ends.

Any Employee-Paid Supplemental Life, Supplemental AD&D or LTD coverage ends on the date your employment ends. Team members will have the option to port and convert their coverage.

 

Special Enrollment Period for Group Health Coverage

If you decline enrollment for yourself or your dependents because of other health insurance coverage, in the future you may be able to enroll yourself or your dependents in VillageMD’s plan if you request enrollment within 30 days after your other coverage ends.

You may enroll in the plan if your or your dependents’ other coverage ends due to one of the following special enrollment events:

  • Loss of eligibility for such other coverage (including a legal separation, divorce, death, termination of employment, reduction in hours or no longer being a dependent),
  • Employer contributions toward the cost of such coverage stop,
  • In the case of COBRA continuation coverage, the maximum COBRA coverage period ends,
  • You and/or your dependent no longer lives or works in an HMO service area and no other benefit option is available,
  • You or your dependent covered under Medicaid or CHIP has coverage terminated as a result of loss of eligibility, and you request coverage under the plan within 60 days after such termination,
  • You or your dependent becomes eligible for Medicaid or CHIP assistance, if you request coverage within 60 days after the eligibility determination date, or
  • The other coverage no longer offers benefits to the class of individuals that includes you and/or your dependents.

This special enrollment period is not available if the prior health insurance coverage ended:

  • For cause,
  • Because required contributions were not paid on a timely basis, or
  • Due to a voluntary disenrollment.