Employees are eligible to enroll or make changes (such as adding/removing dependents or changing plans) to their medical, dental, or vision insurance at these three times:
If you have existing coverage and did not enroll your dependents already, you'll need to wait for your company's open enrollment period, or for a QLE. If you've recently experienced a QLE (e.g., you just had a baby), you can enroll your dependent by following these instructions.
Outside of Open Enrollment, an existing employee (one who is not a new hire) can only make changes to their insurance status if they have experienced a qualifying life event (QLE). Examples of qualifying life events include getting married, giving birth, adopting a child, or a change in your spouse's insurance coverage status.
It is not possible to enroll dependents in a line of coverage or plan that the employee is not enrolled in. The employee must be enrolled in a line of coverage in order to enroll dependents in the same coverage and plan.
If you're a new parent who needs to enroll a newborn within 27 days of their birth (a qualifying life event), you don't need to provide an SSN when adding your newborn to your existing coverage. Newborns often don't receive an SSN until several weeks after their birth, but must be enrolled as a dependent within 27 days of birth.
If you're adding a dependent during your initial or open enrollment period (and not through a QLE), you will need to provide:
Zenefits uses your home address to determine whether you're able to enroll in a particular plan. If you're moving during your enrollment, there's a chance that you may not be able to choose certain plans.
Follow these instructions to update the date of birth, Social Security Number, and other information for the dependents you've enrolled on your insurance coverage.
To update this information with your insurance carriers, reach out to them using the contact information on your member ID Card. If you are unsure of their contact information, please contact your Insurance Broker. Your broker's contact information is listed on your Zenefits account.
During open enrollment, you can see how much it would cost to add your dependents on the plan selection page. Simply check the box next to the person's name you wish to add to that line of coverage, and the cost estimate for each plan will be updated.
If you are outside of open enrollment, the only way to add dependents is through a qualifying life event. If you are within 28 days of a qualifying life event, you can view a cost estimate before enrolling a dependent in the qualifying life event flow.
If you want to decline coverage, you will need to log in to your Zenefits account and verify your information before declining the plans your company offers. Once your information is verified, you can decline coverage by clicking the links at the bottom of the page stating your desire to decline coverage. You will need to complete the rest of the enrollment to generate the decline waiver.
When an employee undergoes a qualifying life event (QLE), they can cancel their health plan by going through the QLE flow in Zenefits.
If you experience a QLE, you can decline coverage by following these steps:
Some carriers offer packages of medical plans that are bundled together with dental and/or vision plans. Employees who choose to enroll in a bundled medical plan must also enroll in the associated dental and/or vision plans.
You can enroll your children as dependents on your medical, dental, or vision insurance plan at three (3) different times: during Initial Enrollment (as a new hire), during Open Enrollment (when your employer renews an existing plan), or due to a qualifying life event (QLE).
If you have existing coverage and did not enroll your child already, you'll need to wait for your company's Open Enrollment period, or for a QLE. If you've experienced a QLE, such as having a baby, you can enroll that child within 27 days of the event by following these instructions.
One of the steps in the enrollment flow in Zenefits asks the enrollee to specify if they smoke or are disabled. This information is included on insurance applications to determine how claims are paid out.
It is up to you to decide how you want to answer these questions, and Zenefits employees will not be able to tell you what you should or should not select. However, the disability question pertains to a) whether or not the employee claims as disabled in their taxes and b) receives disability benefits.
If a worker is transferring from one company to another company within Zenefits, and both companies share the same insurance policy, please contact our Customer Care Team and we will be happy to complete this for you. Zenefits will transfer the worker's benefit information from the original company to the new company with an effective date that aligns with the employment transfer date.
Note: If the companies share an insurance policy, but there are billing groups set up for the individual companies on that policy, Zenefits can transfer the benefits for you, but the broker will need to be contacted to ensure the billing group associated with the worker has been updated with the carrier.
If you're transferring a worker to a linked company that does not share the same insurance policy, the individual will need to be terminated and removed from insurance under the old company profile and enrolled as a new hire under the new company. If you have questions regarding waiving the new hire waiting period under the new employer policy, reach out to your insurance broker for questions and assistance.