What You Can Change

BNY Mellon Benefits Guide

What You Can Change

Any election change you make must satisfy the "consistency rule" explained below, and you may be asked to provide supporting documentation for all life event changes.

The consistency rule means that you can only change benefits that are directly linked to the qualified change you experience. For example, if you move to a new zip code that does not allow coverage for your current health plan, you can change your health plan election. However, if you move from an apartment to a house in the same neighborhood, you cannot change your health plan election, because the life event does not have a direct impact on your medical benefits.

The following table lists some common life event changes and the types of benefit adjustments you may request in each situation.


LIFE EVENT CHANGES
LIFE EVENT	BENEFIT	ALLOWABLE CHANGES
Marriage or Domestic Partnership*	Medical Dental Vision	Add or discontinue coverage for yourself, your spouse/domestic partner and/or new or existing dependents
	Spouse/Domestic Partner Life Child Life	Elect coverage
	Supplemental Life & Accidental Death and Dismemberment (AD&D)	Increase or decrease coverage by one level for yourself
	Health Care FSA	Increase your contributions
	Dependent Care FSA	Elect, increase, decrease or discontinue your contributions
Loss of Spouse or Domestic Partner (divorce, separation, annulment, loss of domestic partner status, death)	Medical Dental Vision	Must discontinue coverage for your former spouse/domestic partner Elect coverage for yourself or dependents who lose coverage under your former spouse's/domestic partner's plan
	Supplemental Life & Accidental Death and Dismemberment (AD&D)	Increase or decrease coverage by one level for yourself
	Spouse/Domestic Partner Life	Discontinue spouse/domestic partner coverage
	Dependent Care FSA	Elect, increase, decrease or discontinue your contributions
Add a New Dependent (birth, adoption, placement for adoption, foster care, legal guardianship)	Medical Dental Vision	Elect coverage for yourself and new or existing dependents
	Spouse/Domestic Partner Life Child Life	Add coverage for dependents
	Health Care FSA	Elect or increase your contributions
	Dependent Care FSA	Elect or increase your contributions
Loss of Dependent (change in eligibility or death)	Medical Dental Vision	Must discontinue coverage for the dependent who loses eligibility
	Dependent Life	Must discontinue coverage for the dependent that loses eligibility
	Dependent Care FSA	Decrease or discontinue your contributions
Employee/Dependent Gains Eligibility for Other Coverage	Medical Dental Vision	Discontinue coverage for dependent or discontinue all coverage
	Supplemental Life & Accidental Death and Dismemberment (AD&D)	Elect, increase, decrease or discontinue your contributions
	Spouse/Domestic Partner Life Child Life	Discontinue coverage
Employee/Dependent Loses Eligibility for Other Coverage	Medical Dental Vision	Add dependents or elect coverage
	Supplemental Life & Accidental Death and Dismemberment (AD&D)	Increase or decrease coverage by one level
	Spouse/Domestic Partner Life Child Life	Elect coverage
	Health Care FSA	Elect or increase contributions
	Dependent Care FSA	Elect, increase, decrease or discontinue your contributions


OTHER EVENTS	ALLOWABLE CHANGES
Certain Court Orders	You may elect medical coverage for your child if a qualified medical child support order (QMCSO) requires coverage under BNY Mellon's plan. You may cancel coverage for your child if your spouse, former spouse or other individual provides coverage for the child because he or she is required to do so due to a judgment, decree or order resulting from a divorce, legal separation, annulment or change in legal custody.
Changes Made Under Another Employer's Plan	You may change your election in response to a change made in your spouse's/domestic partner's employer's plan during that plan's enrollment period. This rule applies only if the other employer's plan has a different plan year.
Significant Change in Medical Provider Network	If there is a substantial decrease in the number of physicians participating in a provider network or an HMO, or if your health plan option is eliminated, you may switch to another health plan option or drop coverage if no other viable option is available. BNY Mellon will determine whether the number of physicians participating in an option has decreased substantially.
Changes in Entitlement for Medicare or Medicaid	If you, your spouse or dependent becomes entitled to coverage under Medicare or Medicaid (other than solely under the program for distribution of pediatric vaccines), you may elect to cancel coverage for the entitled person. Note: If you become entitled to Medicare or Medicaid and currently have a spouse or dependent(s) covered under the BNY Mellon plan, you may not cancel coverage for yourself only. If you cancel your coverage, coverage for your spouse and dependent(s) will end as well.
Loss of Medicare, Medicaid or Group Health Coverage Sponsored by an Educational or Government Institution	If you, your spouse or your eligible dependent loses eligibility for Medicare or Medicaid or loses group health coverage sponsored by an educational or government institution, you may add coverage for this person(s). This includes a state children's health insurance program (CHIP), a medical program of an Indian Tribal government or the Indian Health Service, a state benefits risk pool or a foreign government group health plan.

* Expenses for your domestic partner and your domestic partner's children are not eligible for reimbursement through either of the FSAs.