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Qualifying Changes in Status 

 

Coverage elected during the annual Benefit Choice Period remains in effect throughout the entire plan year, unless the member experiences a Qualifying Change in Status or a special enrollment event which would allow them to change their coverage elections. 

Any request to change an election mid-year must be consistent with the qualifying event the member has experienced.  Members experiencing a Qualifying Change in Status have 60 days to change certain benefit selections.  Members must submit proper supporting documentation to their Group Insurance Representative (GIR) (PDF 314 KB) within the 60-day period in order for the change to become effective. 

Qualifying Change in Status events include, but are not limited to:

  • Events that change an Employee’s legal marital status, including marriage, death of spouse, divorce, legal separation or annulment.
  • Events that change an Employee’s number of Dependents, including birth, death, adoption or placement for adoption.
  • Events that change the employment status of the Employee, the Employee’s Spouse, or the Employee’s Dependent.  Events include termination or commencement of employment, strike or lockout, commencement of or return from an unpaid leave of absence, change in worksite or change in the individual’s employment when they cease to be eligible for the Program.
  • Events that cause an Employee’s Dependent to satisfy or cease to satisfy eligibility requirements for coverage based on age, student status, marital status or any similar circumstance.
  • A change of residence for the Employee, Spouse or Dependent.

See the Qualifying Changes in Status chart for a complete list of qualifying changes and corresponding options.

The following options can be changed anytime during the year.  Coverage options include:

  • Changes in member’s life insurance coverage above $50,000.  Includes Basic Life and any Optional Life insurance coverage.  An approved Statement of Health is required to increase coverage.
  • Changes to Spouse Life or Child Life coverage.  An approved Statement of Health is required to add coverage.
  • Changes to member’s Accidental Death and Dismemberment (AD&D) coverage.  A Statement of Health is not required.
  • Changes in dependent health coverage in the two-or-more Dependent category not affecting the premium may be made at any time. 

Effective Dates

Health, dental and vision coverage changes are effective the later of:

  • The date the request for change was signed.
  • The date the event occurred.

Life insurance increases become effective the Statement of Health approval date.

Flexible Spending Account (FSA) elections/changes become effective the first day of the pay period following the date the request for change was signed or the date of the qualifying event, whichever is later.

There are exceptions to the effective dates for newborns and adopted children.  If the request for change is made within 60 days, coverage may be retroactive to the date of birth or placement for adoption.

Updated 04/29/14