Life Event Guide—Healthcare
Important Note about Life Events…
Remember, election changes are permitted only when the qualifying life event has a direct effect on eligibility for health coverage.
When you experience an important life event—like getting married or having a baby—your benefits under the Stryker Corporation Welfare Benefits Plan may be affected. The "Life Event Guide" below provides an overview of these events and the actions you may want to take to update your healthcare benefits, including medical, prescription drug, vision and dental coverage.
Your Benefits representative must approve benefit election changes. In order to complete the enrollment on a pre-tax basis for a qualifying life event as provided in the following chart, you must properly change your enrollment via the Benefits Enrollment Site at http://enroll.stryker.com, or by contacting your Benefits representative and completing an enrollment form, and provide proof of the life event (if applicable) within 30 days of the life event (including the date of the life event). You must also provide the required dependent documentation within 30 days of the life event (including the date of the event) as requested. In addition, if you wish to change health plan options as specified in the following chart, you must do so within 30 days of the eligible life event.
You cannot drop coverage via the Benefits Enrollment Site without HR approval. If you are dropping coverage for yourself or a dependent, you must complete the enrollment form and return it to your Benefits representative along with proof of the qualifying life event within 90 days of the life event (including the date of the event). If you do not meet this deadline, you will not be able to change your election until the next annual enrollment period, unless you experience another qualifying life event that would permit an election change.
Please note that if you have a COBRA qualifying life event, you must notify your Benefits representative and submit the appropriate documentation within 60 days of the qualifying event date in order to be eligible for COBRA continuation coverage.
If you are adding coverage and submit all of the requested documentation more than 30 days (including dependent documentation) but less than 120 days of the event, your change will be effective but all new contributions will be deducted from your paycheck on a post-tax basis for the remainder of the plan year in which you properly completed the enrollment (and payable retroactively to the date of the qualifying life event). However, you may not switch health plan options as specified in the following chart more than 30 days after your qualifying life event. If you don't properly change your enrollment and submit all of the requested documentation within 120 days of the event, you will have to wait until the next annual enrollment period to make any changes to your healthcare benefit election, unless you experience another qualifying life event that would permit an election change prior to that time. (Fully insured plans are administered by insurance carriers that do not always agree to the extension of benefits. Please contact your Benefits representative for confirmation.)
If failure to enroll within this timeframe is due to circumstances beyond your control, please submit an appeal for further consideration as instructed in the Medical and Rx Claims Procedures, Dental or Vision section.
Life Event Guide
Qualifying Life Event
Permissible Election Change
Marriage, declaration or registration of a domestic partner with any state or local government, birth, adoption, placement for adoption, appointment of legal guardianship, acquiring a stepchild or placement of a foster child
You may add your new spouse, new domestic partner or newly acquired dependent child to the medical and prescription drug, dental and/or vision coverage. You may also add any other eligible dependents who were not previously covered under this plan.
If you previously declined coverage, you may enroll yourself, your spouse, your domestic partner and/or any eligible dependent child in the medical and prescription drug, dental and/or vision coverage.
You may drop medical and prescription drug, dental and/or vision coverage if you become enrolled for similar coverage under your spouse's or domestic partner's plan.
With a marriage, domestic partnership, birth, adoption or placement of adoption, you may change health plan options (e.g. from an HMO to PPO).
Death of dependent, divorce, annulment or termination of domestic partnership, termination of an adopted or foster child's placement or end of guardianship appointment
Note: Legal separation is not considered a qualifying life event
You must drop the affected dependent's medical and prescription drug, dental and/or vision coverage.
You may enroll yourself and any eligible dependents in similar coverage if the event causes a loss of coverage under your spouse or domestic partner's plan.
Change in the employment status of employee, spouse, domestic partner or dependent (e.g., change in work hours, change between salaried and hourly and leaves of absence)
You may enroll for medical and prescription drug, dental and/or vision coverage if the change in employment status results in a loss of eligibility for other similar coverage. If there is a change in employment status of your spouse, domestic or civil union partner or dependent that results in a loss of eligibility under their employer's plan, you may enroll them in similar coverage as well as other eligible dependents not previously covered.
You may drop medical and prescription drug, dental and/or vision coverage if the change in employment status results in eligibility for other similar coverage and you are enrolled in another medical and prescription drug, dental and/or vision plan(s).
Dependent loses benefit eligibility under Stryker's plan (for example, the dependent reaches age 26)
You may drop the affected dependent's medical and prescription drug, dental and/or vision coverage.
Dependent newly satisfies eligibility requirement under Stryker's plan
You may add the newly eligible dependent that satisfies the plan eligibility requirement as well as other previously eligible dependents not covered under the plan.
Change in residence or work site
You may change to another similar plan option or drop coverage if the event results in loss of eligibility under your current plan option.
Dependent moves to the United States from another country
You may enroll your dependent(s) for medical and prescription drug, dental and/or vision coverage. Your contributions for any coverage you elect will be made on an after-tax basis for the remainder of the plan year in which Stryker was notified.
Loss of other employer, government or educational institution sponsored medical coverage by employee, spouse, domestic partner or dependent
You may enroll yourself and/or your spouse, domestic partner or dependents in the medical and prescription drug, dental and/or vision plan(s) if other similar coverage is lost due to:
  • Exhaustion of COBRA;
  • Loss of eligibility; or
  • Termination of employer contributions as an active employee only.
You may add any other eligible dependents that were not previously covered under this plan.
You may change health plan options (e.g. from an HMO to PPO).
Employee or dependent becomes eligible for or loses eligibility for Medicare or Medicaid
You may drop medical and prescription drug, dental and/or vision coverage for the affected individual upon entitlement to Medicare or Medicaid.
You may enroll yourself and/or the affected individual for medical and prescription drug, dental and/or vision coverage upon loss of similar coverage through Medicare, Medicaid or CHIP eligibility, and if you are already covered under the Stryker Health and Welfare Plan.
You may also change health plan options (e.g. HMO to PPO).
Court issues order regarding medical coverage of child (qualified medical child support order (QMCSO)) or National Medical Support Notice (NMSN)
You may enroll your child in medical and prescription drug, dental and/or vision coverage. If you are not currently covered, you must also be added to the same plan(s).
You may drop similar coverage for your child if another individual is ordered to provide medical and prescription drug, dental and/or vision coverage for the child under a QMCSO or NMSN and coverage is in fact provided.
Significant increase in cost or significant curtailment of coverage under an employer-sponsored plan
If the plan increase occurs mid-year under this plan and you have other plan options under this plan, you may elect similar coverage under this plan or you may drop coverage if you enroll in a similar plan with another employer. If no other plan options are available to you under this plan, you may drop coverage for the medical, dental or vision plan to which the cost increase is associated.
If you are electing similar coverage, you may also add any other eligible dependents that were not previously covered under this plan.
Enrollment period for coverage under another employer's plan occurs while your elections are in effect
You may drop medical and prescription drug, dental and/or vision coverage if you become enrolled for similar coverage under another employer's plan.
You may enroll for medical and prescription drug, dental and/or vision coverage if similar coverage under the other employer's plan was dropped during that plan's enrollment period.
Reduction in hours of service
You and your covered dependents may drop your group health plan coverage, even if you remain eligible for such coverage, if:
  • You were reasonably expected to work 30 hours per week and you experience a change in employment, after which you are reasonably expected to work less than 30 hours per week
  • You enroll yourself and your covered dependents that are dropping coverage in another health plan (satisfying the Affordable Care Act's definition of minimum essential coverage) effective no later than the first day of the 2nd month after you drop Stryker health coverage.
Enrollment in a health plan offered through the public Marketplace
If you are eligible for a special enrollment period to enroll in public Marketplace coverage, or you want to enroll in public Marketplace coverage during the public Marketplace's annual open enrollment period, you may drop Stryker group health plan coverage, even if you remain eligible for Stryker coverage. You (and any dependents whose coverage is dropped at this time) must enroll in Marketplace coverage that is effective no later than the day immediately following the last day your coverage under the Stryker Health and Welfare Plan is dropped.
Remember, election changes are permitted only when the qualifying life event has a direct effect on eligibility for health coverage.