45-06-12-04. Special enrollment periods for certain dependent beneficiaries.

1. A group health benefit plan that makes coverage available with respect to dependents of a participant is required to provide a special enrollment period to permit individuals described in this section to be enrolled for coverage under the terms of the plan if the enrollment is requested within the time period described in subsection 7. The enrollment is effective at the time described in subsection 8. The special enrollment rights under this section apply without regard to the dates on which an individual would otherwise be able to enroll under the plan.

2. An individual is described in this section if: a. The individual is an employee who is eligible, but not enrolled, in the plan; b. The individual would be a participant but for a prior election by the individual not to enroll in the plan during a previous enrollment period; and c. A person becomes a dependent of the individual through marriage, birth, adoption, or placement for adoption.

3. An individual is described in this section if either: a. The individual becomes the spouse of a participant; or b. The individual is a spouse of a participant and a child becomes a dependent of a participant through birth, adoption, or placement for adoption.

4. An employee who is eligible, but not enrolled, in the plan, and an individual who is a dependent of such employee, is described in this section if the employee would be a participant but for a prior election by the employee not to enroll in the plan during a previous enrollment period, and either: a. The employee and the individual become married; or

1. b. The employee and the individual are married and a child becomes a dependent of the employee through birth, adoption, or placement for adoption.5. An individual is described in this section if:- a. The individual is a dependent of a participant; and
2. b. The individual becomes a dependent of such participant through marriage, birth, adoption, or placement for adoption.6. An employee who is eligible, but not enrolled, in the plan, and an individual who is a dependent of such employee, is described in this section if:- a. The employee would be a participant but for a prior election by the employee not to enroll in the plan during a previous enrollment period; and
3. b. The dependent becomes a dependent of the employee through marriage, birth, adoption, or placement for adoption.7. The special enrollment period under this section is a period of not less than thirty days and begins on the date of marriage, birth, adoption, or placement for adoption. The period does not begin earlier than the date the plan makes dependent coverage generally available.8. Enrollment is effective:- a. In the case of marriage, not later than the first day of the first calendar month beginning after the date the completed request for enrollment is received by the plan;
4. b. In the case of a dependent's birth, the date of such birth; and
5. c. In the case of a dependent's adoption or placement for adoption, the date of such adoption or placement for adoption.

History: Effective December 1, 1997.

General Authority: NDCC 28-32-02(1)

Law Implemented: NDCC 26.1-36.4