The following chart shows certain common changes in employment, personal or family status that may allow you to make mid-year changes to your current elections under various Costco benefit plans. Keep in mind:
• Any benefit changes you make must be on account of and consistent with the qualified Change in Status or other event.
• Adding or increasing coverage under the Supplemental Life Insurance plan may require Evidence of Insurability (EOI). In that case, your elected coverage will not go into effect unless the insurance company, Unum, approves your application in writing. It’s your responsibility to make sure you receive this written approval.
• You may change Long Term Care Insurance elections at any time subject to EOI requirements and approval from Unum subject to the rules described in Providing Evidence of Insurability, starting on page 101.
This chart is only a quick guideline to changes you may be allowed to make. Available election changes will depend on your actual circumstances.
To find out the options for your particular circumstances, be sure to contact the Costco Employee Benefits Department, 1-800-284-4882 weekdays from 7:00 am to 5:00 pm Pacific Time.
If you have this event as an
eligible Employee:
You may be able to make these mid-year
election changes: Your deadline for changing
elections after the event: When your benefit changes will take effect:
• Switch to other available medical and/or dental options participation or increase contributions if you acquire a child who is a Qualified Individual
60 days.
If Costco approves, you may enroll the child for healthcare coverage up to 12 months after the event but there may be some consequences, as described in Deadlines for Making Mid-Year Election Changes, starting on page 32.
Healthcare:
Retroactive to the date of the event Supplemental AD&D: Retroactive to the date of the event
Dependent Care Assistance Plan:
First payroll after you change your elections
If you have this event as an eligible Employee:
You may be able to make these
mid-year election changes: Your deadline for changing
elections after the event: When your benefit changes will take effect: or increase contributions the child is a Qualified Individual (not applicable if your Domestic Partner is the Legal Guardian)
30 days Healthcare: Retroactive to the date of the event
Supplemental Life Insurance:
Retroactive to the date of the event Supplemental AD&D: Retroactive to the date of the event
Dependent Care Assistance Plan:
First payroll after you change your elections
3. You get married Healthcare:
• Enroll yourself, your Spouse, your Stepchildren and any other Eligible Family Members not already enrolled,
• Switch to other available medical and/or dental options.
Supplemental Life Insurance:
• Add or increase coverage for yourself.
• Enroll your new Spouse and any other Eligible Family Members not currently enrolled
Supplemental AD&D: Add family coverage
Dependent Care Assistance Plan:
Enroll or increase contributions if you acquire a family member who is a Qualified Individual
30 days Healthcare: Retroactive to the date
of the event
Supplemental Life and AD&D Insurance: Retroactive to the date of the event
Dependent Care Assistance Plan:
First payroll after you change your elections
If you have this event as an eligible Employee:
You may be able to make these mid-year
election changes: Your deadline for changing
elections after the event: When your benefit changes will take effect: member who has lost eligibility will end but you must notify Costco of the event at www.costcobenefits.com or via the your Dependent is no longer a Qualified Individual due to the event
60 days Healthcare: Automatically ends
midnight on the date of the event that causes loss of eligibility Supplemental Life Insurance:
Retroactive to date of the event Supplemental AD&D: Retroactive to the date of the event
Dependent Care Assistance Plan:
First payroll after you change your elections
• Switch to other medical or dental options available to Employees with the same classification as you
30 days Healthcare: Retroactive to the date
of re-classification Insurance Plan. If you were:
• Previously Hourly, now Salaried, your coverage will end automatically
• Previously Salaried, now Hourly, your coverage will begin automatically (does not apply to California, Hawaii, New Jersey, or New York)
31 days to decline Voluntary STD (if you’re changing from Salaried to Hourly)
Voluntary Short Term Disability:
Retroactive to the date of the re-classification (unless you’re an Hourly Employee and decline coverage)
If you have this event as an eligible Employee:
You may be able to make these
mid-year election changes: Your deadline for changing
elections after the event: When your benefit changes will take effect:
• Enroll the persons who lost the other coverage
• Switch yourself and enrolled family members to another available medical or dental option
60 days Healthcare: Retroactive to the date
of the event
Healthcare: Drop Costco healthcare for the
person who enrolls for the other coverage 60 days Healthcare: Date other coverage becomes effective
• Enroll the person who gets the subsidy
• Switch yourself and enrolled family members to another available medical or dental option
60 days Healthcare: Retroactive to the date
of the event
10. You begin working
at a new Location Healthcare: Switch to another available medical plan Decline coverage if you move to or from Hawaii or Puerto Rico
Voluntary Short Term Disability (Hourly Employees): Coverage begins automatic if you move out of California, Hawaii, New Jersey or New York into another state Dependent Care Assistance Plan: Add, decline or adjust current contributions to reflect your new childcare situation
30 days (31 days to decline
Voluntary STD) Healthcare: Retroactive to the date of the event
Voluntary STD: Retroactive to the date you move to the new location (unless you decline coverage) Dependent Care Assistance Plan:
First payroll after you change your elections
If you have this event as an eligible Employee:
You may be able to make these
mid-year election changes: Your deadline for changing
elections after the event: When your benefit changes will take effect:
11. Your childcare
situation changes Dependent Care Assistance Plan:
• Change current contributions if you have an increase or decrease in provider costs
• End contributions if your dependent care expenses are no longer eligible for reimbursement, for example, because your child reaches age 13 or your Spouse becomes unemployed
• Enroll if expenses become eligible for reimbursement, for example, because your Spouse begins employment
30 days Dependent Care Assistance Plan:
First payroll after you change your elections