Status Change Matrix

Events Permitting Election Change

Applicable Regulation

Notes
  1. Change in Status

Six categories of events with strict consistency rules. Only events fitting within one of the categories can support an election change and the change must be absolutely consistent with the event.

  • Change in employee’s legal marital status
  • Change in number of dependents
  • Change in employment status
  • Dependent satisfies or ceases to satisfy dependent eligibility requirements
  • Change in residence
  • Commencement or termination of adoption proceedings

Final Treas. Reg. § 1.125-4(c) (2000)

Applies the change in status rules to accident or health coverage & GTL only. Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
 

Prop. Treas. Reg. § 1.125-4 (c) (2000)

Adds the adoption assistance category, and extends the rules to all qualified benefits, including DCAPs and adoption assistance. Can be relied on now.
 

Prior Rules:

Temp Treas. Reg. § 1.125-4T (c) (1997)

Applies the change in status rules to accident or health coverage & GTL only. Expires soon; can be relied on only for plan years beginning on or before 11/6/2000.
 

Prior Rules:

Temp Treas. Reg. § 1.125-4, Q/A-6(c) (1989), amended 1997, withdrawn and republished 2000

After the 1997 amendment, except as provided in #6 below, Q/A-6(c) applies only to qualified benefits other than accident or health plans and GTL (i.e., to DCAPs and adoption assistance plans). Both Q/A-6(c) and Prop. Treas. Reg. § 1.125-4 (c) (2000), which extends the final change in status regulations to DCAPs and adoption assistance plans, can be relied upon.
  1. Cost Changes, with automatic increase/decreases

Prop. Treas. Reg. § 1.125-4 (f)(2)(i) (2000)

Applies to DCAPs, self-funded health plans (but not health FSAs), insured health plans, and other qualified benefits. Can be relied on now.
 

Prior Rules:

Prop. Treas. Reg. § 1.125-2, Q/A-6(b)(1) (1989

Applied rules to insured health plans only. 2000 proposed regulations acknowledge that old rules can continue to be relied upon, but it is unlikely they would provide any additional leeway.
  • Significant Cost Increases
    		•

    Prop. Treas. Reg. § 1.125-4 (f)(2)(ii) (2000)

    Applies to DCAPs, self-funded health plans (but not health FSAs), insured health plans, and other qualified benefits. Can be relied on now.
     

    Prior Rules:

    Prop. Treas. Reg. § 1.125-2, Q/A-6(b)(1) (1989

    Applied rules to insured health plans only. 2000 proposed regulations acknowledge that old rules can continue to be relied upon, but it is unlikely they would provide any additional leeway
  • Significant Coverage Curtailment
    		•

    Prop. Treas. Reg. § 1.125-4 (f)(3)(i) (2000)

    Applies to DCAPs, self-funded health plans (but not health FSAs), insured health plans, and other qualified benefits. Can be relied on now.
     

    Prior Rules:

    Prop. Treas. Reg. § 1.125-2, Q/A-6(b)(2) (1989

    Applied rules to insured health plans only. 2000 proposed regulations acknowledge that old rules can continue to be relied upon, but it is unlikely they would provide any additional leeway
  • Addition or Elimination of Benefit Package Option
    		•

    Prop. Treas. Reg. § 1.125-4 (f)(3)(ii) (2000)

    Applies to DCAPs, self-funded health plans (but not health FSAs), insured health plans, and other qualified benefits. Can be relied on now.
  • Change in Coverage of Spouse or Dependent Under Other Employer’s Plan
    		•

    Prop. Treas. Reg. § 1.125-4 (f)(4) (2000)

    Applies to DCAPs, self-funded health plans (but not health FSAs), insured health plans, and other qualified benefits. Can be relied on now.
     

    Prior Rules:

    Temp Treas. Reg. § 1.125-2, Q/A-6(c) (1989), amended 1997, withdrawn and republished 2000

    Applied to accident or health plans where there is a significant change in the health coverage of the employee or spouse attributable to the spouse’s employment.

    2000 proposed regulations acknowledge that old rules can continue to be relied upon, but it is unlike they would provide any additional leeway.
  • Cessation of Required Contributions
    		•

    Prop. Treas. Reg. § 1.125-2, Q/A-6(e)(1989)

    Disregard this exception as if virtually never applies.
  • Separation from Service
    		•

    Final Treas. Reg. § 1.125-4(c)(2)(iii) (2000) (the change in status rules; exception #1 above)

    Applies the rules to accident or health coverage & GTL only.

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prop. Treas. Reg. § 1.125-4 (c) (2000)

    Adds the adoption assistance category, and extends the rules to all qualified benefits, including DCAPs and adoption assistance. Can be relied on now.
     

    Prior Rules:

    Prop. Treas. Reg. § 1.125-4, Q/A-6(d) (1989), amended 1997, withdrawn and republished 2000

    After 1997 amendment, the rules apply only to qualified benefits other than accident or health plans and GTL (i.e., to DCAPS and adoption assistance plans).

    2000 proposed regulations acknowledge that old rules can continue to be relied upon, but it is unlikely they would provide any additional leeway.
  • FMLA Leave
    		•

    Final Treas. Reg. § 1.125-4(g) (2000)

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prior Rules:

    Prop. Treas. Reg. § 1.125-3 (1995)

    Presumably the 1995 proposed regulations, which deal exclusively with FMLA issues, can continue to be relied on.
  • Changes in 401K Contributions
    		•

    Final Treas. Reg. § 1.125-4(h) (2000)

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prior Rules:

    Temp. Treas. Reg. § 1.125-4T(j) (1997)

    Expires soon; can be relied on only for plan years beginning on or before 11/6/2000.
  • HIPAA Special Enrollments
    		•

    Final Treas. Reg. § 1.125-4(b) (2000)

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prior Rules:

    Temp. Treas. Reg. § 1.125-4T(b) (1997)

    Expires soon; can be relied on only for plan years beginning on or before 11/6/2000.
  • COBRA Events
    		•

    Final Treas. Reg. § 1.125-4(c)(3)(iv) (2000)

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prior Rules:

    Temp. Treas. Reg. § 1.125-4T(c) 3)(ii) (1997)

    Expires soon; can be relied on only for plan years beginning on or before 11/6/2000.
  • Judgment, Decree or Order
    		•

    Final Treas. Reg. § 1.125-4(d) (2000)

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prior Rules:

    Temp. Treas. Reg. § 1.125-4T(d) (1997)

    Expires soon; can be relied on only for plan years beginning on or before 11/6/2000.
  • Medicare or Medicaid Entitlement

    • Final Treas. Reg. § 1.125-4(e) (2000)

    Mandatory compliance for plan years beginning on or after 1/1/2001; but can be relied on now.
     

    Prior Rules:

    Temp. Treas. Reg. § 1.125-4T(e) (1997)

    Expires soon; can be relied on only for plan years beginning on or before 11/6/2000.