Life Changes Require Health Choices: Know Your Benefit Options
Life is full of changes, both joyful and challenging. These changes often impact more than just your day-to-day routine—they can significantly affect your financial security, health coverage, and overall peace of mind. Having the right health and life insurance plans in place ensures you and your loved ones are protected, no matter what life throws your way.
Let’s explore how key life events—like marriage, having children, or even facing loss—require adjustments to your insurance coverage and how understanding your benefit options empowers you to make the best choices.
Marriage: A New Beginning with New Responsibilities
Marriage is a celebration of love and partnership, but it also comes with important financial and health-related considerations. For many, it’s the first time they need to think beyond individual health coverage and plan for a future together.
What You Need to Know
When you get married, you have several options for updating your health coverage:
Adding yourself, your spouse, and any children to one employer’s plan.
Joining your spouse’s employer’s plan.
Exploring coverage through the Health Insurance Marketplace.
Marriage qualifies you for a special enrollment period, giving you the chance to change or secure coverage outside the usual enrollment windows. Understanding how plans differ—benefits, deductibles, premiums, and doctor networks—can help you decide what’s best for your family.
What You Need to Do
Time is critical here. For employer-sponsored plans, you have 30 days after your wedding to request enrollment. If you opt for a Marketplace plan, you have 60 days to make your selection. Taking these steps promptly ensures uninterrupted coverage and sets the foundation for a healthy future together.
Welcoming a New Member to Your Family
The arrival of a child—whether through birth, adoption, or placement—brings immense joy and a whole new level of responsibility. This life change often requires immediate updates to your health and life insurance policies.
What You Need to Know
Most employer plans and all Marketplace plans cover essential maternity and newborn care, and most Private Health plans also provide coverage for maternity, with exception to Short Term Medical (STM) plans.. Additionally, they typically offer well-baby and well-child visits with no copayments if you use in-network providers.
Special enrollment periods are triggered by events like childbirth, adoption, or placement for adoption, allowing you to:
Add your child to an employer-sponsored plan.
Enroll in or update a Marketplace plan.
The Newborns’ and Mothers’ Health Protection Act ensures coverage for hospital stays of at least 48 hours following a vaginal delivery or 96 hours for a cesarean section, unless you choose otherwise in consultation with your doctor.
What You Need to Do
Review your current health plan’s Summary Plan Description (SPD) to understand what’s covered.
Notify your employer or health plan provider within 30 days of the event to add your child to your coverage.
If using the Health Insurance Marketplace, enroll your child within 60 days of their arrival.
When Your Child Grows Up
Time flies, and before you know it, your child may no longer qualify as a dependent under your health plan.
What You Need to Know
Most ACA plans allow dependent children to remain covered until age 26, and Private plans typically allow dependent children to remain covered until age 24, 25, or 26 in they are a full-time student, depending on the plan. After that, they have several options:
Enrolling in their own employer-sponsored plan.
Enrolling in a Private Health plan.
Joining a Marketplace plan during a special enrollment period.
Extending their coverage for up to 36 months through COBRA.
What You Need to Do
Ensure your child enrolls in their own Private Health plan within 30 days of aging out of your coverage.
Ensure your child enrolls in a Marketplace or COBRA plan within 60 days of aging out of your coverage.
If choosing COBRA, notify your employer in writing. COBRA coverage can provide a vital safety net during this transition.
Death, Divorce, and Legal Separation: Protecting What Matters
No one likes to think about life’s darker moments, but loss or separation is often when insurance becomes most critical.
What You Need to Know
When an employee covered under a health plan passes away, legally separates, or divorces, the remaining spouse and dependents may face sudden coverage loss. Fortunately, options like COBRA or special enrollment in a new plan can bridge the gap.
COBRA allows eligible individuals to continue existing coverage for up to 36 months. Marketplace plans also offer special enrollment options for those losing coverage due to these events.
What You Need to Do
Notify the health plan of the event promptly. For divorce or separation, this must typically be done in writing within 60 days.
Evaluate the spouse’s employer-provided plan, Private plan options, or Marketplace options to ensure uninterrupted coverage.
Why Life Insurance Matters Through Every Stage
While health insurance protects against the cost of medical care, life insurance ensures financial stability for your loved ones when you’re no longer there to provide for them.
Starting a Family
As you welcome a spouse or child, life insurance becomes a cornerstone of financial planning. Consider increasing your coverage to account for mortgage payments, college tuition, or your partner’s income needs.
Planning for the Future
When children grow up or you approach retirement, your life insurance needs may decrease. A term life policy might be sufficient, or you could explore permanent life insurance for estate planning and wealth transfer.
After a Loss
The death of a spouse or dependent child can profoundly affect your financial situation. Review and adjust your policy to reflect your new circumstances, whether it’s reducing coverage or updating beneficiaries.
Why Knowing Your Benefit Options is Key
Understanding your options is the first step in taking control of your coverage. By staying informed and proactive, you can make decisions that best suit your evolving needs. Here’s how:
Educate Yourself: Familiarize yourself with the details of your current plans, including deductibles, premiums, and benefits.
Seek Expert Advice: A licensed broker can help you compare plans, understand your rights, and choose the coverage that fits your life.
Act Quickly: Life changes often come with time-sensitive opportunities to update your coverage. Don’t miss out.
How We Can Help
Navigating the maze of health and life insurance options can feel overwhelming, but you don’t have to do it alone. As your trusted advisor, we’re here to help you make sense of it all. From answering questions about special enrollment to guiding you through policy adjustments, we’re committed to ensuring you and your family are protected through every twist and turn of life.
Contact us today to learn more about your options. Let’s take this journey together to build a stronger, healthier future for you and your loved ones.
