As of July 1, 2021, the administration of your House Officer (Resident Physician) medical, dental, vision, life and disability coverage transitioned from Graduate Medical Education (GME) over to the UNM’s Benefits & Employee Wellness (BEW) team.
The UNM-sponsored group health plans have a pre-tax status and are, therefore, governed by IRS regulations. Once you in enroll in coverage for medical, dental, vision, or a Flexible Spending Account, you cannot make changes* to these plans outside of the annual Open Enrollment period, unless you experience a Qualifying Change in Status Event (also knowns as a Qualifying Life Event).
Changes to your coverage must be made within the following designated timelines from your Change in Status Event by submitting your Enrollment Change Form(s) to UNM’s Benefits & Employee Wellness (BEW) department.
Submit your Enrollment / Change Form(s) to Benefits & Employee Wellness via Secure Document Submission Upload at https://hr.unm.edu/secure-upload or fax to 505-277-2278. You may also submit it to the UNM HR Service Center, located at 1700 Lomas Blvd NE, Suite 1400.
Do you need to add or drop a dependent or make a change to your health coverage? Our health plans have limited enrollment change windows:
Submission timeline for mid-year (Qualifying Change in Status) enrollment changes:
If you experience a Qualifying Change in Status Event, you have a limited window to submit enrollment changes to UNM’s BEW. If you miss submitting an enrollment change form within in the timelines stated above for any of the following events, you will have to wait to make these changes during the next annual Open Enrollment period.
Open Enrollment is typically held every April/May for a July 1 election change effective date.
Qualifying Change in Status Events include, but are not limited to, the following. Keep in mind that the change in benefits you are seeking must match the event that occurred. A change in one type of event may not allow for a change in other benefit elections. For example, if you have a child, you may not use that event to also discontinue dental coverage for a spouse.
Use the Qualifying Change In Status Event: Required Support Documentation guide to help identify documents you may have that demonstrate the event you have experienced from the list above.
It is critical that you submit your Enrollment Form within the designated timelines listed above for your Qualifying Change in Status Event, even if you are still waiting for your supporting documentation of the event (i.e. birth certificate/proof of birth, proof of loss/gain of other coverage from the other insurance entity, marriage certificate etc.).
Do not wait for your documentation or you risk missing your 60-calendar day deadline.
The Transparency in Coverage Rule, issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor, and U.S. Department of the Treasury, requires insurers and group health plans to publish machine-readable files starting July 1, 2022. These files contain in-network rates and out-of-network allowed amounts. Under the Transparency in Coverage Final Rule, plans and issuers will disclose pricing information to the public through machine readable files accessible via a table of contents file. One file requires disclosure of negotiated rates between plans and providers for covered items and services, known as the In-Network File. The second file discloses unique allowed amounts and billed charges for out-of-network services, known as the Out-of-Network Allowed Amount File.
The machine-readable files for UNM Medical Plans can be accessed from the link below:
For information on changes in coverage, please contact Benefits & Employee Wellness and request to speak to a Benefit Specialist.
