Dependent Gains or Loses Medicaid Coverage
Qualifying Life Event
A dependent’s enrollment in Medicaid coverage is generally a qualifying life event. If your dependent enrolls in or terminates Medicaid coverage, you’ll have 60 days to request conditional changes to your State Health Plan and NCFLex benefits. That 60-day window starts on the date the coverage becomes effective or on the date of Medicaid coverage termination.
Effective Date of Coverage
The effective date for your benefits change will be the first day of the month following the date the Medicaid coverage became effective.
Only certain changes to NCFlex benefit plans are permitted if a dependent gains or loses Medicaid coverage. Review both the “Loss of Medicaid or CHIP Coverage” and “Gain of Medicaid/CHIP Coverage” sections on this NCFlex table to see which changes are permitted.
Required Documents
If your dependent enrolls in or drops Medicaid and you want to make changes to your benefits as a result, you will need to provide documents in support of your request. Acceptable documents include a written notification showing the dependent’s name and the effective date of the dependent’s coverage or the benefit ID card that shows the effective date of coverage, or the effective date of coverage termination. Please note that an “issued date” or “print date” is not the same as an effective date and is not acceptable.
How To Request Changes and Upload Documents
You can request changes to your benefits due to a qualifying event and submit documents in support of your request through the employee benefits enrollment portal, via MyPack portal.