Timeline for Health and Welfare Benefit Enrollment
The following chart lists the time frames within which you must enroll for various types of events, and the consequences of not meeting these time frames.
Type of Enrollment
Time Frame
Consequence of Not Meeting Time Frame
First-Time Enrollment
Changes are effective the first day of the month following receipt of your elections, provided you complete an enrollment form within 31 days of your date of hire or transfer.
New Hire
You may enroll yourself and Eligible Dependents within 31 days of hire.
You will receive Default Coverage for yourself only (see "Default Coverage" under "I Join PG&E").
Transfer from Management or Administrative & Technical position
You may enroll yourself and Eligible Dependents within 31 days of transfer.
You will receive limited coverage, as described under "I Transfer from Management or Administrative & Technical Positions."
Change-in-Status Events
Changes are effective the first day of the month following timely notification. (See "Change-in-Status Events and Other Changes Involving a Registered Domestic Partnership or Same-Sex Marriage" under "Change in Status Events" for additional information.)
NOTE: Changes in the status (other than termination) of a registered domestic partnership or same-sex marriage and changes concerning children of a registered domestic partnership or same-sex marriage do not qualify as a change-in-status event unless the affected individual is your tax dependent. See "Change-in-Status Events and Other Changes Involving a Registered Domestic Partnership or Same-Sex Marriage" under "Change in Status Events."
Marriage or Establishment of a Registered Domestic Partnership
You may add yourself or Eligible Dependents within 31 days of marriage or establishment of a registered domestic partnership.
You will not be able to enroll in or add Eligible Dependents to the medical, dental, or vision plans until the next Open Enrollment period, unless you have another eligible change-in-status event or qualify for a HIPAA special enrollment period, and the change is consistent with the event.
Divorce or Legal Separation (must be final), Annulment or Termination of a Registered Domestic Partnership
You must drop your ex-spouse, registered domestic partner, step-children, and any other former dependents within 31 days of final decree or termination of a registered domestic partnership. You may also drop other dependents.
If you cover Ineligible Dependents, you will be required to pay the Company an amount equal to the cost of the insured or HMO premiums (or self-insured premium equivalents) for the period of time during which an Ineligible Dependent is enrolled, up to a maximum of two years of premiums or premium equivalents.
Birth or Adoption of Child
You may add yourself, your spouse, the newborn or adopted child, and other Eligible Dependents within 60 days of birth or adoption (assumption of physical custody or financial responsibility). You must notify the PG&E Benefits Service Center, not your medical plan, of any change-in-status events.
Anthem Blue Cross-Administered Plans — Your newborn or newly-adopted child's medical coverage will terminate on the 60th day. While your child is not enrolled, no medical expenses for the child will be covered by the Plan. You will not be able to enroll in or add Eligible Dependents to the medical, dental or vision plans until the next Open Enrollment period, unless you have another eligible change-in-status event or qualify for a HIPAA special enrollment period, and the change is consistent with the event.
HMOs — You must wait for the next Open Enrollment period to enroll your newborn or newly-adopted child or other Eligible Dependents in your medical, dental, and vision plans if you miss the 60-day deadline, unless you have another change-in-status event or qualify for a HIPAA special enrollment period, and the change is consistent with the event. In addition, your newborn or newly-adopted child's medical expenses will not be covered retroactive to the date of birth or adoption; please check with your HMO for more details on coverage for newborn and newly-adopted children.
No Medical Plan — You will not be able to enroll in or add Eligible Dependents to the medical, dental or vision plans until the next Open Enrollment period, unless you have another eligible change-in-status event or qualify for a HIPAA special enrollment period, and the change is consistent with the event.
Employee's Court Appointment of Legal Guardianship or Becoming a Foster Parent
You may add your legal ward or foster child within 31 days of appointment of legal guardianship or placement for foster care.
You will not be able to enroll Eligible Dependents in the medical, dental or vision plans until the next Open Enrollment period, unless you have a change-in-status event and the change is consistent with the event.
Dropping Enrollment Due to Death of Dependent
You must drop enrollment of your deceased dependent within 31 days of your dependent`s death.
If you cover Ineligible Dependents, you will be required to pay the Company an amount equal to the cost of the insured or HMO premiums (or self-insured premium equivalents) for the period of time during which the Ineligible Dependent is enrolled, up to a maximum of two years of premiums or premium equivalents.
Dropping Enrollment Due to Dependent's Loss of Eligibility
You must drop enrollment of an Ineligible Dependent within 31 days of the dependent`s loss of eligibility.
If you cover Ineligible Dependents, you will be required to pay the Company an amount equal to the cost of the insured or HMO premiums (or self-insured premium equivalents) for the period of time during which the Ineligible Dependent is enrolled, up to a maximum of two years of premiums or premium equivalents.
Dependent Regains Eligibility
You may add a dependent within 31 days of the date on which the dependent regains eligibility.
You will not be able to enroll in or add Eligible Dependents to the medical, dental or vision plans until the next Open Enrollment period, unless you have another eligible change-in-status event and the change is consistent with the event.
Start or End of Spouse's/Registered Domestic Partner's Employment
You may add or drop your spouse/registered domestic partner within 31 days of the start/end of spouse`s/registered domestic partner's employment.
You will not be able to add or drop your spouse/registered domestic partner until the next annual Open Enrollment period, unless you have another change-in-status event or qualify for a HIPAA special enrollment period and the change is consistent with the event.
You or Your Spouse/Registered Domestic Partner Changes from Full-Time to Part-Time Employment or Vice Versa
You may add or drop your spouse/registered domestic partner and other Eligible Dependents within 31 days of the change.
You will not be able to add or drop your spouse/registered domestic partner until the next annual Open Enrollment period, unless you have another change-in-status event or qualify for a HIPAA special enrollment period and the change is consistent with the event.
Spouse/Registered Domestic Partner Has Significant Change of Health Coverage at Place of Employment
You may add or drop yourself, your spouse/registered domestic partner, and other dependents as consistent with the change within 31 days of change.
You will not be able to add or drop yourself, your spouse/registered domestic partner, and other dependents until the next annual Open Enrollment period, unless you have another change-in-status event or qualify for a HIPAA special enrollment period and the change is consistent with the event.
Move out of HMO Area
You must change plans within 31 days of the move, or within 31 days of the date on which your dependent child moves to attend school outside of the HMO's service territory.
You or your child may not be eligible for services under your HMO, or you may receive lower benefits. For information on services for dependent students who are living away from home, contact Member Services of the plan in which you are enrolled.
Annual Open Enrollment
Annual Open Enrollment (for following calendar year)
You may add or drop yourself and Eligible Dependents within the designated Open Enrollment period.
Your current elections (if the plans are available) and dependent coverage will continue into the following year, with the exception of the Health Care Reimbursement Account and the Dependent Care Reimbursement Account, if applicable. If you want to contribute to one or both of the Reimbursement Accounts, you must actively enroll during Open Enrollment.
Retirement
Your Retirement
You may add yourself or your Eligible Dependents (if not currently enrolled) at the time of your retirement. You may also change medical plans.
You will not be able to enroll yourself or Eligible Dependents to the retiree medical plan until the next Open Enrollment period. If you decline medical coverage and want to subsequently enroll, you must notify the PG&E Benefits Service Center by September 1 in order to receive an Open Enrollment package for the following plan year. As a retiree, you may only make changes on a mid-year basis if you are already enrolled in a medical plan and have a change-in-status event that allows for a change.