Qualifying Life Events
An individual may make a mid-year election change when it is because of and consistent with a qualifying life event or when certain significant changes in cost or in coverage occur.
A qualifying life event includes:
- legal separation, annulment, or divorce
- the death of your spouse or child
- the birth or adoption (or placement for adoption) of your child
- the loss or gain of benefit eligibility of your child
- the termination or commencement of employment of you or your spouse or child
- for active employees: a reduction or increase in hours of employment of you or your spouse or child, including a switch between part-time and full-time, a strike or lockout, or commencement of or return from unpaid leave of absence
- a change in health coverage due to your spouse’s employment
- a “special enrollment period” under the group health plan as required by law
- a qualified medical child support order that requires your child to be covered under the group medical and/or dental plan
- you or your spouse or child becomes eligible (or loses eligibility) for Medicare or Medicaid
or
- involuntary loss of other group health plan coverage.
REMINDER: Enrollment forms must be completed AND submitted to the Benefit Plans Office within 30 calendar days of any qualifying life event. THIS INCLUDES THE BIRTH OF A NEWBORN. Otherwise, you will have to wait until Open Enrollment to enroll and the coverage will not be effective until the next January 1.
Here are a few examples of election changes that are consistent with a qualifying life event and plan eligibility rules:
With This Event |
You Can Make These Changes |
You have a qualifying life event, such as:
- divorce or legal separation
- birth or adoption
- death
- change in your spouse’s employment status
|
Medical Plan
Major Medical Medicare Supplement Plan
Dental Plan |
If you were previously enrolled for coverage, you can add dependents (consistent with the family status change and subject to eligibility limits of each plan) or drop coverage or dependents
Note: You cannot add a spouse or child to your medical or dental coverage due to re-marriage after retirement. |
You experience a loss of other employer-provided medical or dental coverage |
Medical Plan
Major Medical Medicare Supplement Plan
Dental Plan |
Add coverage by providing proof of the coverage loss within 30 days of the loss |
You move outside a point-of-service network |
Medical Plan |
Change coverage to the CIGNA Indemnity Plan |
Benefit changes must be requested within 30 days of the qualifying life event by completing a change form and returning it to the Benefit Plans Office. However, there is one exception: you have up to one year to enroll a newborn for MetLife dental coverage and three years to enroll a newborn for Delta Dental coverage. All changes are effective on the date of the event. |