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Qualifying Life Events

Significant life events may affect an employee's benefits, creating a need for change during the year. Examples of such qualifying life events include marriage, divorce, birth, adoption, and changing employment status from full-time to part-time.

This page highlights qualifying life events, describes how your benefits may be affected, and lists actions you must take in order to change your benefits.

NOTE: Most benefits changes are effective the first of the month following receipt of appropriate completed forms in the UA Benefits Office.

Qualifying Life Events include the following:

Employment Status Changes

Change from full-time to part-time or part-time to full-time, employment ends, retirement, Leave of Absence, or salary increase/decrease over/under $20,000.

Possible Changes:

Medical/Dental

  • Terminate health/dental plans if employment changes from full to part-time or part to full time or if employment ends.
  • Employees less than 100% appointed when hired who waived health/dental can enroll in health/dental if appointment changes to 100%.
  • Continue Retiree Health/Dental benefits if eligible for Retiree benefits.
  • Employees going on an unpaid Leave of Absence must pay 100% of the total cost (employer & employee) premiums to keep benefits. Employees on FMLA may be eligible for continued employer contributions. Employees going on an Unpaid Leave of Absence can cancel health/dental and reinstate coverage when returning from leave or may transfer cover to UA employed spouse's plan.

LTD

  • Add optional Long Term Disability if salary increases over $20,000 without having to provide Evidence of Insurability.

Monday, September 14, 2009 6:33 PM

Family Status Changes

Spouse and Dependent Changes include marriage, legal separation, divorce, birth, adoption, dependent attaining the age of 19, dependent over the age of 19 enrolling or un-enrolling in college full time or dependent attainment of the age 25.

Possible changes:

  • Medical/Dental: Add or delete dependents from health plan.
  • Health Care Reimbursement Plan: Increase/decrease annual election (changes allowed only for Marriage, divorce, birth, death, or adoption).
  • Dependent Care Reimbursement Plan: Increase or decrease annual election.

Monday, September 14, 2009 6:33 PM

HIPAA Changes

The Health Insurance Portability and Accountability Act allows employees to enroll in coverage or add dependents to their existing health/dental plans if they have one of the following Qualifying Events. Changes must be consistent with the event.

  • New Hire: Employees have 31 days from their benefits-eligible appointment dates to enroll in health/dental coverage.
  • Marry, have a child, have a child placed in home for adoption: Employees have 31 days from the birth date or the date the child is placed in the home for adoption to add new child to health/dental.

Employees who waived coverage as new employees or who neglected to enroll within 31 days of their benefits eligibility dates, who chose not to cover their dependents, or who neglected to enroll new dependents within 31 days of the qualifying event date may enroll themselves or their eligible dependents in coverage at a later date only when:

  • Eligibility for other COBRA coverage ceases.
  • Employees and/or dependents ceases to be eligible for other coverage (voluntarily canceling other coverage is not a qualifying event)
  • Employer contributions for other coverage ceases.
  • Employee is court ordered to provide coverage for a dependent.

Action Required: If you choose to change any of the eligible benefits, you must complete the appropriate form and return it to the Benefits Office within 31 days after the date of the event.

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Effective Dates

Below you will find the effective dates of changes you make to your health/dental plans within 31 days of an eligible qualifying event. Changes will be effective as of the dates listed below as long as 31 day enrollment period required is adhered to.

  • Birth or placement of adoption of child: Coverage retroactive to date of birth or date child placed in home for adoption.
  • Employee marries: New spouse covered effective the 1st day of the month following the date completed forms are received by Human Resources
  • Employee enrolls in health/dental or adds dependent to existing plan for other HIPAA qualifying events: 1st day of the month following the date completed enrollment forms are received by Benefits Office.

Important Disclaimer: your actual rights and benefits are governed by official Plan descriptions (see full Disclaimer for more information).

Monday, September 14, 2009 6:31 PM

When Can I Make Changes?

Elections for Premium Conversion (tax-exempt insurance premiums), Dependent Care Reimbursement, and Health Care Reimbursement may begin, change, or end during the calendar year only if one of the following events occur and the requested change is consistent with the event.

NOTE: You must complete and submit the required forms within 31 days of one of the following events.

EVENTS THAT ALLOW CHANGES TO YOUR FLEXIBLE BENEFIT PLAN

*P = Premium Conversion, D = Dependent Care Reimbursement, H = Health Care Reimbursement

*Allows Changes To:

P D H
Change in Status      
  1. Change in the employee's legal marital status: marriage, divorce, death of spouse, legal separation, and annulment.
X X X
  1. Change in the employee's number of tax dependents: birth, death, adoption, and placement for adoption
X X X
  1. Change in the employment status of the employee, spouse or dependent: commencement or termination of employment; a strike or lockout; commencement or return from an unpaid leave of absence; full-time to part-time or part-time to full-time.
X X  
  1. Dependent satisfies (or ceases to satisfy) dependent eligibility requirements: due to age, student status, marriage or similar circumstances
X X  

Automatic Cost Change

If the cost of a qualified benefit increases (or decreases) during the plan year, the employee's affected contributions will be adjusted accordingly.

X    

Significant Cost Changes

If the cost of a qualified benefit increases (or decreases) significantly during the plan year, the plan may permit affected employees to either keep existing coverage with an election increase for cost changes or make a new election (subject to plan limitations) for coverage under another benefit package option that provides similar coverage.

X X  

Significant Curtailment of Coverage

If coverage under a qualified benefit is significantly curtailed or ceases, the affected employee may make a new election for coverage under another benefit package option providing similar coverage. Coverage is significantly curtailed only if there is an overall reduction in coverage for plan participants.

X    
Addition or Elimination of Benefit Package Option X    

Change in Coverage of Spouse or Dependent Under Another Employer's Plan

An employee is able to make a corresponding election change when coverage is elected under a spouse's plan during open enrollment.
The first time offering of family coverage under a spouse's employer's plan would enable an employee to make a corresponding change (coverage must be elected under spouse's employer's plan).

X X  
Separation from Service X X  

Family Medical Leave Act (FMLA) leave

This exception applies to employees taking or returning from FMLA.

X X  
HIPAA Special Enrollment Rights      
  1. Loss of Coverage: a change may be made to elect coverage for an employee, spouse, or dependent who has lost other group health coverage.
X    
  1. Acquisition of new dependent: through birth, marriage, adoption or placement for adoption.
X    

COBRA Qualifying Event

An employee may increase his/her pre-tax contributions for coverage under a current employer's plan if a COBRA event occurs with respect to the employee, the employee's spouse or dependent. For example, loss of eligibility due to a reduction in work hours or dependent status.
NOTE: Does not apply to contributions for COBRA coverage under another employer's plan.

X    
Judgments, Decrees, or Orders

An employee may add or drop coverage consistent with a judgment, decree, or order resulting from a divorce, legal separation, annulment, or change in legal custody (including a qualified medical child support order).

X    

The Entitlement TO or LOSS of Medicare or Medicaid

Entitlement to Medicare or Medicaid would allow a corresponding prospective election change. Loss of Medicare or Medicaid would also allow a corresponding prospective election change.

X    

Monday, September 14, 2009 6:29 PM