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. See Effective Dates Section.
Qualifying Life Events include the following. See the chart in
When Can I Make Changes? for a list of which changes apply to
which qualifying events.
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.
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.
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.
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 date employee
turns in completed forms adding new spouse to the Benefits Office.
- 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).
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 |
|
|
|
- Change in the employee's legal marital status: marriage, divorce,
death of spouse, legal separation, and annulment.
|
X |
X |
X |
- Change in the employee's number of tax dependents: birth, death,
adoption, and placement for adoption
|
X |
X |
X |
- 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 |
|
- 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 |
|
|
|
- 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 |
|
|
- 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 |
|
|
|