You may change the level of your elections during the year if you have any of the following changes in status:

To change your coverage, you must submit an online Benefits Change Request to your benefit administrator within 31 days of your change in status. You must provide documentation (for example, a birth certificate) that supports the change in status. The change you request must be consistent with the change in status you experience. Your change will not go into effect until the required documentation has been received and the change has been approved.

If you do not submit your change of status form within 31 days of the event, you must wait until the next annual enrollment period to make a change to your coverage. You may not change the health plan you are enrolled in during a calendar year due to a qualifying event.

The Summary of Allowable Status Changes table below describes the changes in coverage you may make when you experience a change in status. Any change must be consistent with the change in status as interpreted in the tax laws.

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you may be entitled to enroll in group health plans (medical, dental, vision and flexible spending account) offered by the company at times other than the annual enrollment period. If you decline DallasNews Corporation’s health coverage because you have other coverage and you later lose that coverage or gain a dependent, you or your dependent may have special enrollment rights. The enrollment must be consistent with the change you experience. You must enroll within 31 days of the event that caused your special enrollment rights or you will lose your special enrollment rights for that event.

If the event giving rise to your special enrollment right is a loss of coverage under Medicaid or the Children’s Health Insurance Program (CHIP), you may request enrollment under the DallasNews Corporation health plans within 60 days of the date you or your dependent(s) lose such coverage under Medicaid or CHIP. Similarly, if you or your dependent(s) become eligible for a state-granted premium subsidy toward the DallasNews Corporation health plans, you may request enrollment within 60 days after the date Medicaid or CHIP determine that you or the dependent(s) qualify for the subsidy.

You are entitled to enroll in a group health plan offered by DallasNews Corporation when:

Even if you are not then covered by any group health plan offered by DallasNews Corporation, you, your spouse and new dependent child may enroll because of your marriage or the birth or adoption of your child. However, you must request enrollment within the applicable time period following the event, as described above. In the case of any dependents who lose other coverage, they must have been and remain eligible under the DallasNews Corporation group health plans at the time of the last annual enrollment. Losing eligibility or exhausting COBRA coverage does not include failing to pay premiums on a timely basis or having your other coverage terminated for cause.

To request special enrollment or obtain more information, please contact DallasNews Corporation Benefits at (214) 977-7210.

The following table lists the changes you are allowed to make due to qualified changes in status and indicates whether the event would potentially give you special enrollment rights or allow you to make changes to current elections. Any change must be consistent with the change in status as interpreted in the tax laws.

Complete your enrollment form within 31 days of the change in status (within 60 days if the event is loss of coverage under or new eligibility for premium subsidy under Medicaid or CHIP). The new coverage for birth, adoption or Qualified Medical Child Support Order (QMCSO) is effective on the date of the event. For marriage, coverage is effective on the first day of the following month. If you do not submit the enrollment form within 31 days of the change, you may not change your benefit elections until the next annual enrollment (unless you have a change in status, described in Changing Your Coverage, that allows you to enroll earlier).

Note: For dropping a dependent, the change is effective the end of the month in which the qualifying event occurs. If a dependent becomes ineligible and you do not notify your benefit administrator within the 31 days, the dependent will still be considered ineligible for benefits.

If you wish to enroll at some time after you first become eligible or after you have dropped coverage, you may do so during the next annual enrollment. Coverage will take effect on January 1 of the following year if you complete the enrollment form, you do not have an allowable status change and provide proof of good health, if applicable. If you are not actively at work when you enroll, your basic, supplemental and dependent life insurance, AD&D insurance and long-term disability coverage would not take effect until you return to work and can perform the regular duties of your job for one full day. If you have an allowable status change that permits you to enroll in the coverage you want, you may enroll in such coverage after annual enrollment, provided you request to make a change in your coverage elections within 31 days of your status change event (60 days for Medicaid or CHIP eligibility).

Because the company provides basic life insurance and you pay for your supplemental life insurance and dependent life insurance coverage on an after-tax basis, plan provisions and not IRS rules dictate changes. Requests to increase or elect coverage for the first time must be submitted with 31 days of a change in status or during the annual enrollment period. Requests to decrease or drop coverage can be submitted in writing at any time and will be processed according to payroll and carrier deadlines.

Proof of good health will be required if: