LAPRA 2018 Legally Required Notices

1 Required Notifications and Other Important Information Section 125 Important Announcement for Active Members Please Read Carefully The medical and dental plans provided by LAPRA to active members are subject to Section 125 of the Internal Revenue Code. As provided under Section 125, once you make a benefit election for you and, if applicable, your family, you will generally not be able to change your election until the next annual open enrollment period. Except in the limited situations described below, the benefits you choose must remain in effect throughout the plan year (July 1 – June 30). Once you elect to enroll in or decline coverage for you, your spouse, or dependent, you may only change that election according to the following rules: • You may add a new spouse or dependent to your coverage only if: – You become legally married. (See note on page 2 regarding domestic partners.) – You acquire a new dependent. If you enroll in a medical plan a new dependent that you acquired through birth, adoption, or placement for adoption, and your spouse is eligible but not enrolled for coverage in that plan, you may also enroll your spouse in that plan. – There is a court order directing that a dependent be added to your coverage. – You are called to or return from active duty in the uniformed services. • You may drop a spouse or dependent from your coverage only if: – You become divorced or legally separated, your marriage is annulled, or your spouse dies. – You lose a dependent. – Your spouse or dependent moves, and due to the move, your spouse or dependent is no longer eligible for coverage under your plan. – There is a court order directing that a dependent be removed from your coverage. – You are called to or return from active duty in the uniformed services. • If you are not enrolled in a LAPRA plan, you may enroll for coverage only if: – You return from an unpaid leave of absence. – You also enroll for coverage a new dependent that you have acquired through marriage, birth, adoption, or placement for adoption. – You had declined coverage because you were covered under another plan (including federal COBRA continuation coverage) and you lose eligibility for coverage under that plan (or in the case of federal COBRA coverage, you exhaust such coverage). – You are called to or return from active duty in the uniformed services. • If you are enrolled in a LAPRA plan, you may drop that coverage only if: – You move, and due to the move, you are no longer eligible for coverage under your plan. – You are on an unpaid leave of absence. – You are called to or return from active duty in the uniformed services. • If you are enrolled in a LAPRA plan, you may change plans only if: – All of the following apply: (i) you, your spouse, or your dependent moves, (ii) due to the move, you, your spouse, or your dependent is no longer eligible for coverage under the plan you were enrolled in, and (iii) coverage for you, your spouse, or your dependent is available under the plan in which you wish to enroll. – You are called to or return from active duty in the uniformed services.