Open Enrollment Options
May 16, 2011
I have been working for the same company for 5 years. Our open enrollment period will begin within the next few weeks. Our fiscal year begins on September 1. I tested positive six months ago. I am currently covered under my companys group health and life insurance policy and dental plan. My insurance policy is a small $25,000 policy. This fiscal year I elected to set up a flexible spending account in the amount of $600. It has really helped to meet my co-pays when visiting my doctors. The other benefits available to employees are Short and Long Term Disability, Cancer Insurance, Vision Insurance and Health Flexible Spending Account. My questions are as follows: 1. Will I be able to increase my life insurance benefit/coverage? 2. Under current law/policy, would I qualify for short or long term disability? 3. Will I still be able to set up a flexible spending account? I would greatly appreciate a response as soon as possible! Thank you for all the guidance and assistance you and your colleagues provide on the forums!
Response from Ms. Franzoi
1. It depends on the terms of your life insurance plan. Most plans offer what is called a guaranteed issue amount, i.e., an amount that you can get without providing any medical evidence. Anything in excess of that amount would require completing a medical questionnaire and possibly lab work. Since you are HIV+, you probably won't qualify for coverage in excess of the guaranteed issue amount. Your Summary Plan Description for your life insurance plan should explain what would be required if you want coverage in excess of the $25,000 that you currently have.
2. It sounds like you did not sign up for short term or long term disability coverages (STD and LTD) when they were first offered to you (probably when you initially became eligible for benefits at your company). If this is the case, the STD and LTD carrier would require you to complete a medical questionnaire. Since you are HIV+, they might not want to extend coverage to you. However, if your company is offering an open enrollment with respect to STD and LTD that does not require medical evidence (which companies sometimes negotiate with their insurance carriers), you would be able to get the coverage.
3. You would be eligible to enroll in the flexible spending account.
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