Change Guidelines

LSS Insurance

Group Health Change Guidelines

CHANGE GUIDLINES

ELIGIBILITY

Dependents

Eligible dependents generally include your spoue and any children financially dependent upon you up to a certain age.

Different companies have different requirements these are just general guidlines. Call your agent or insurance company for specific guidelines. These are just general guidelines.

The age limit of a dependent child may also differ from company to company this should also be checked with your agent or insurance company.

Spouse generally means a lawful spouse or a commonlaw spouse established by a court of law or valid order.

A child generally is an unmarried child who is under the age limit, who is financially dependent on you or your spouse for more than half of their support. Support includes food, shelter, medical care, education, clothing, ect. The child should either be a natural or legally adopted child of you or your spouse or a child placed for purposes of adoption with you or your spouse documented by a court order or a child legally placed in your custody or legal guardianship if the natural parent is not eligible for insurance.

CHANGES

Changes to a policy are usually life events such as termination of job, birth or adoption of a child, marriage, divorce, etc. Again you should always check with your agent or insurance company as to the exact procedures to make changes.

Newborns or newly adopted children, new spouses generally must be added to a policy within 30 days. If a child is not added within the 30 days then they must wait until the open enrollement of the policy. When this happens they are subject to a preexisting condition waiting period.

Preexisting conditions are considered any treatments, diagnosis or advice by a physician. The waiting period for this is usually one year but again this should be verified by your agent or insurance company.

You may waive a portion of your preexisting waiting period by showing proof of prior insurance as long as there was not a 90 day gap between in force policies. This may show that your preexisiting waiting period was satisfied by your previous policy.

Making Changes

Making changes such as those talked about above can usually be done by filling out a change form. If you are terminating a policy a letter may need to be written instead. Also certain changes may require documentation such as copies of marriage certificates, adoption certificates or court papers