Enrollment in the Premium Conversion Program remains in effect during the Plan Year and your status cannot change unless an approved Qualifying Event occurs mid-year.

Similarly, employees who waived enrollment in the Premium Conversion Program may enroll mid-year only if they incur a Qualifying Event listed below:

• A change in family status such as marriage, divorce, annulment or legal separation;
• The death of a participant, spouse, or dependent;
• The birth or adoption of a child who will be the participant's dependent;
• The attainment of the maximum age for coverage of a dependent child;
• The participant becomes divorced and is required under court order to provide health insurance coverage for eligible dependent children;
• A choice of another carrier (e.g., resulting from a move out of an HMO service area);
• A participant has a change in title which necessitates a change in health plan (e.g., Med-Team participants must be DC-37 members; Metropolitan participants must be HHC employees);
• The termination of the participant's employment for any reason including retirement;
• A change in spouse's coverage that is significant and outside the spouse's control (e.g., due to termination of employment or benefit reduction);
• A spouse has a change in employment status that results in a change for health insurance coverage (either acquiring or losing eligibility for coverage);
• A change in employment status from part-time to full-time, or vice-versa, by the participant or the participant's spouse;
• The taking of, or returning from, an approved unpaid leave of absence by the participant or the participant's spouse;
• An increase in the employee's health insurance contribution amount by more than 20%.

Download the MSC Premium Conversion Program Enrollment/Change Form (PDF)
Read the MSC Premium Conversion FAQ