"Late enrollee" defined.

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58-18-43. Late enrollee determined.

For the purposes of this chapter, a late enrollee is an eligible employee or dependent who requests enrollment in a health benefit plan of an employer following the initial enrollment period during which the individual is entitled to enroll under the terms of the health benefit plan, if the initial enrollment period is a period of at least thirty days. However, no eligible employee or dependent may be considered a late enrollee if:

(1)The individual:

(a)Was covered under creditable coverage at the time of the initial enrollment;

(b)Lost coverage under creditable coverage as a result of termination of employment or eligibility, reduction of hours, the involuntary termination of the creditable coverage, death of a spouse, legal separation, or divorce; and

(c)Requests enrollment within sixty-three days after termination of the creditable coverage;

(2)The individual is employed by an employer that offers multiple health benefit plans and the individual elects a different plan during an open enrollment period;

(3)A court has ordered coverage be provided for a spouse or minor or dependent child under a covered employee's health benefit plan and request for enrollment is made within thirty days after issuance of the court order; or

(4)Child custody has changed by agreement of the parties to a child custody agreement or to a child custody order which agreement has not yet been included in a court order.

Source: SL 1994, ch 383, §2; SL 1997, ch 289, §7.


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