All changes to benefit plans must be processed through the Plano ISD Benefits and Risk Management Department.
Anyone newly added to the Plan at any time is subject to pre-existing condition limitations. (Birth/adoption may be exempt if addition requested within first 30 days.)
Newborn children are not automatically covered upon birth. Employees must request their enrollment within 30 days of birth. (See below.)

When Can I Change My Benefits?

1. Annual Open Enrollment

Each November, employees receive an instruction booklet to guide them through the online open enrollment process. Employees may request any type of change, and all changes requested at that time will become effective January 1 of the next calendar year. The deadline to request open enrollment changes is always early December.

2. Change in Status

The Internal Revenue Service (IRS) allows certain benefit changes to be made mid-year, only as a result of a "change in status". This can include marriage, divorce, birth, adoption, death, significant change in spouse's employer's insurance coverage or eligibility, and dependent ineligibility.

To request a benefit change as a result of a change in status, you must contact the Benefits and Risk Management Department within 60 days, or within 30 days to enroll a newborn child as of the child's birthdate or a newly-adopted child as of the placement date. (You can request addition of a newborn or newly-adopted child later than the first 30 days and before the regular 60 day deadline; however, coverage will not begin on the birthdate or date of placement.)

The benefit change will be effective the first of the month after the change in status occurs. Changes can only be made 1) on the first of a month; 2) after the change in status has occurred; 3) no earlier than the month in which the change is requested; and 4) no later than 60 calendar days since the change in status occurred.

We will send the necessary form requiring the employee's signature. The signed change form must be returned along with documentation of the change in status. This could be a copy of the marriage license, copy of the divorce papers, copy of adoption papers, or a letter from your spouse's employer. We will let you know exactly what you need to return to us and when it is due.

Which Members of My Family May I Cover?

You may request coverage for your spouse or eligible unmarried children under the guidelines below.

"Child" can be a natural child, legally-adopted child, foster child, stepchild, or grandchild.
A child must be a dependent of the employee for federal income tax purposes at the time of enrollment (whether or not a dependency exemption is claimed) or must be required to be covered by the employee by a Qualified Medical Child Support Order. However, coverage for an eligible grandchild will not be terminated solely because the child ceases to be principally dependent upon the employee for support and maintenance, and a child may be considered a dependent for federal income tax purposes even if the child does not reside with the employee.
An eligible child may be covered from birth to the end of the calendar month in which he/she reaches age 25.
An eligible child may be covered past age 25 provided the child is primarily supported by the employee and incapable of self-sustaining employment by reason of mental or physical handicap. Proof of this criteria must be submitted to the Contract Administrator within 31 days after the child's 25th birthday.

Excluded as dependents are:

anyone legally separated (where permitted by law) or divorced from the employee
anyone on active military duty for any country (except to the extent required by law)
a child who is employed full-time and/or covered under his or her employer's group health plan
a child who is or has ever been married
anyone who fails to meet any of the eligibility criteria