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Qualifying Life Events

Changing Your Benefits Outside the Annual Enrollment Period

A qualifying life event is a change in your situation that may allow you to alter your benefit elections. 

Benefit changes must correspond with your specific life event. For example: If you get married, you may add your spouse to the benefit plan, but you may not drop coverages you have already elected.

When you experience a qualifying life event, you must complete benefit changes within 30 days of the event. For example: If you have a baby on September 1, your newborn must be added to the plan no later than September 30.

If you have questions about qualifying life events or you need to make changes to your benefits, contact your employer's Human Resources Department. If you're not sure who to contact, click here to reach out to Benefit Innovations.

List of Qualifying Life Events

Changes in Your Household

  • You get married

  • You get divorced

  • You have a baby

  • You adopt a child

  • Your spouse or child dies

  • You, your spouse, or your dependent experience a change in employment status

  • Your dependent becomes eligible according to the plan's eligibility rules

  • Your dependent no longer satisfies the plan's eligibility rules

Changes in Your Residence

  • You move to a new zip code or county which significantly affects your access to benefits

  • Your dependent child is a student moving to or from the place they attend school

  • You are a seasonal worker moving to or from the place you both live and work

  • You are moving to or from a shelter or other transitional housing

Changes in Your Income

  • Changes in your income that affect the coverage you qualify for

  • Reduction in your hours of service

  • You're taking approved FMLA leave

  • You are taking an employer-approved unpaid leave of absence

  • You, your spouse, or your dependent become eligible to enroll in Marketplace coverage

Changes in Your Coverage

  • You, your spouse, or your dependent lose health coverage elsewhere, including job-based, individual, and student plans

  • You, your spouse, or your dependent gain health coverage elsewhere, including job-based, individual, and student plans

  • There is a significant cost change for your benefits 

  • There is a significant curtailment of coverage (this can be a complete loss of coverage or another significant change, such as an increase in the deductible, copayment, or out-of-pocket) 

  • There is an addition or significant improvement in benefits package options

  • There is a significant change in coverage under your spouse's or dependent's employer plan

  • You, your spouse, or your dependent become eligible for Medicaid, Medicare, or other government-sponsored health plan

  • You, your spouse, or your dependent ceases to be eligible for Medicaid, Medicare, or other government-sponsored health plan

Other Qualifying Events

  • Judgments, decrees, or orders (including QMCSOs)

  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

  • Becoming a U.S. citizen

  • Leaving incarceration (jail or prison)

  • HIPAA special enrollment rights

  • COBRA qualifying event

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