Qualifying Event

To make changes to benefits outside of an open-enrollment period, employees must have experienced an applicable Qualifying Event (also known as a Life Event), as defined by the Internal Revenue Service (IRS). Changes based on financial reasons alone are not allowed under the current IRS regulations.

The request for a change of benefits must be made within 30 days of the applicable Qualifying Event.  All qualifying events that result in a dependent being ineligible to be covered on the plan MUST be reported to Human Resources*.   

Within the context of changing benefits, "applicable" refers to a change that is directly related to the individual experiencing the qualifying event.

"Qualifying Events" include:

  • A birth or an adoption

  • Marriage, divorce or legal separation

  • Death

  • Child loses eligibility because of age or marriage

  • Employee's spouse gains or loses coverage through employment

  • Significant change in the financial terms of health benefits provided through a spouse's employer or another carrier

  • Change in employment status (from full-time to part-time or part-time to full-time)

Except for coverage of a newborn, all other changes in coverage begin the first day of the month following the qualifying event. Coverage for the newborn is effective on the child's date of birth. The premiums for newborn coverage cannot be pro-rated and must be paid for the entire birth month.

*Qualifying events that result in a dependent becoming ineligible to be covered on the plan (divorce, death, child over age 26, etc.) MUST be reported to Human Resources within 30 days.  Failure to report these changes will result in the dependent being retroactively removed per plan rules; however, we will be unable to refund or change future premiums as regulated by the IRS until the next annual open enrollment.   

Please click on the link below for the required form, fill out completely and return to Human Resources.

Benefit Change Form

Benefit Change Form Eff. 7/1/2018