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Phia Group Media


HIPAA Special Enrollment vs. Section 125 Permitted Election Change – There is a difference!

By: Jennifer McCormick, Esq.

An individual may want to adjust their health plan enrollment. For example, if a plan member’s spouse loses plan coverage due a reduction in hours it will likely trigger a HIPAA special enrollment under the health plan.  However, if that spouse discontinues their plan coverage because premiums increased a HIPAA special enrollment would not be triggered.   A permitted election change is separate, and would be outlined within the Section 125 cafeteria plan, not the health plan. HIPAA special enrollments and Section 125 permitted election changes do not necessarily overlap, and must be reviewed on a case by case basis.