Qualifying Life Event

Qualifying Life Event

Updated 04.19.2021

WHAT IS A QUALIFYING LIFE EVENT FOR HEALTH INSURANCE?

A qualifying life event can make an employee eligible for a special enrollment period outside of yearly open enrollment. A qualifying life event is a life-changing situation — sometimes planned, sometimes unexpected — that can impact you and your health insurance. Experiencing a significant life change may allow you to change your health plan midyear or outside of the open enrollment period.

Examples of these events are:

  • Marriage or Divorce
  • Birth or adoption of a child
  • Death of a dependent (spouse or child)
  • Gained coverage elsewhere
    • Gained coverage from another employer
      • This may apply to yourself or your dependents (spouse or child under the age of 26).
    • Federal or State provided medical coverage for yourself or dependents
      • Ex: AHCCCS, SCHIP, Medicare, etc.
    • Loss of coverage elsewhere
      • State assistance expired or revoked (due to dependent age or increased earnings resulting in loss of eligibility).
      • Another employer coverage no longer available due to reduced hours or termination.
      • End of COBRA coverage

WHAT ACTION DO I NEED TO TAKE IF I EXPERIENCE A QUALIFYING LIFE EVENT?

Reporting a life event happens in Dayforce by submitting the Life Event Declaration Form and you will need to include documentation as an attachment to that form.  A job aide for submitted the Life Declaration Form is available here. The submitted documentation needs to include the name of the person who is affected and the date that the event happened and needs to come from an employer or the insurance provider.

HOW LONG DO I HAVE AFTER A QUALIFYING LIFE EVENT TO SUBMIT A LIFE DECLARATION FORM?

You have 30 days from the date that a life event occurs to report this change to Mister AND to complete your benefit elections. Changes older than 30 days are considered outside of the eligibility window and can no longer be considered. These changes cannot be reflected until the next annual open enrollment period.

For additional assistance, please call your Care Coordinators at Quantum Health

at 1-888-971-7277 or email [email protected]

 

 

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