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Life event changes
Benefit plans can be affected by life event changes, some of which qualify as an official change in status by the IRS. Generally, when you enroll in benefits as a new employee, you cannot make any changes until the next Open Enrollment period. However, if you experience a qualified change in status you can make mid-year changes.
Some examples of changes that you may make include:
- Change the number of people covered under your plans
- Enroll in or discontinue your coverage
- Begin a new / change an existing Medical or Dependent Care Flexible Spending Account
What is a life event change?
A life event change, also called a qualifying event, is a personal change in status which may allow you to change your benefit elections.
Examples of some qualifying events include, but are not limited to, the following:
- Change in legal marital status – marriage, divorce, legal separation, annulment, or death of a spouse
- Change in number of dependents – birth, death, adoption, placement for adoption, award of legal guardianship
- Change in employment status of the employee’s spouse or employee’s dependent – switching from part-time to full-time employment status or from full-time to part-time, termination or commencement of employment, a strike or lockout, commencement of or return from an unpaid leave of absence which results in employee/dependent becoming ineligible for coverage
- Dependent satisfies or ceases to satisfy eligibility requirement
What to do if you experience a qualifying event
If you experience a qualifying event, you will need request a change to your benefits within 30 calendar days of the event and provide required documentation. If you do not request the change within 30 calendar days, the next opportunity you will have to make changes to your benefits will be during the next open enrollment period.
You must contact State Personnel Benefits to remove dependents who no longer meet eligibility previously mentioned (Ex-spouse, lost guardianship on ward, etc.). Even outside of 30 calendar days, these life changing events must still be reported to remove ineligible dependents from your coverage. Failure to remove ineligible dependents within the time limit can lead to penalties including disciplinary action or prosecution.
Who do you contact?
If you work in a non-centralized agency, please contact your Agency Benefits Coordinator for assistance in making changes to your benefits. If you work in a centralized agency whose benefits are administered by the State Personnel Department Benefits Division, contact the Benefits Hotline at:
1-877-248-0007 toll-free outside the 317 area code
Special enrollment rights
If you declined enrollment for yourself or your dependents (including your spouse) at the time of your hire because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in a state-sponsored benefit plan if you or your dependents lose eligibility for the other health insurance or group health plan coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 30 days after you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption or placement for adoption.
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