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5
Qualifying Life Events
You will not be allowed to change your plan selections or add dependents until the next benefit year (starting April 1,
2018) unless you have a Qualifying Life Event. Qualifying Life Events can include marriage, divorce, birth or adoption.
Changes must be submitted to Ultipro within 31 days of the life event. The change effective date will be determined by
the Qualifying Life Event date that allows for no break in service.
The following are considered Qualifying Life Events:
•
Change in legal marital status, including
marriage, divorce, legal separation, annulment, or
death of a spouse
•
Change in number of dependents, including birth,
adoption, placement for adoption, or death of a
dependent child
•
Change in employment status, including the start
or termination of employment by you, your
spouse, or your dependent child
•
Change in work schedule, including an increase
or decrease in hours of employment by you, your
spouse, or your dependent child, including a
switch between part-time and full-time
employment that affects eligibility for benefits
•
Change in a child’s dependent status, either
newly satisfying the requirements for dependent
child status or ceasing to satisfy them
•
Change in place of residence or worksite,
including a change that affects the accessibility
of network providers
•
An event that is allowed under Children’s Health
Insurance Program (CHIP) Reauthorization Act:
Under the provisions of the Act. See CHIP Notice
on page 31 of this guide for details
•
Reduction in hours, when an employee’s hours of
service are reduced so that he/she is expected to
average less than 30 hours of service per week,
but the reduction does not affect his/her eligibility
for coverage under the employer’s group health
plan
•
To purchase marketplace coverage, when an
employee seeks to cease coverage under the
employer’s group health plan and purchases
coverage through the Marketplace, without having
to incur a period of either duplicate coverage or
no coverage
•
Change in your health coverage or your spouse’s
coverage attributable to your spouse’s
employment
•
Change in an individual’s eligibility for Medicare
or Medicaid
•
A court order resulting from a divorce, legal
separation, annulment, or change in legal custody
(including a Qualified Medical Child Support
Order) requiring coverage for your child or
dependent foster child
•
A special event under HIPAA (the Health
Insurance Portability and Accountability Act),
including acquisition of a new dependent or
spouse or loss of coverage under another health
insurance policy or plan if the coverage is
terminated because of:
•
Voluntary or involuntary termination of
employment or reduction in hours of
employment or death, divorce, or legal
separation
•
Termination of employer contributions
toward the other coverage, or
•
If the other coverage was COBRA
Continuation Coverage, exhaustion of the
coverage