Due to IRS guidelines, you cannot make changes to your health insurance benefits outside of your employer's annual open enrollment period unless you experience a qualifying life event (QLE). A QLE makes you eligible for a special enrollment period.

You have 30 days from the date of your qualifying event to submit your requested change and you will be asked to include:

  1. Supporting documents

  2. The date the change occurred.

Outside of the special enrollment period, the only opportunity to make a change is during our annual open enrollment (or if you experience another qualifying life event).

You do have the option to update/make changes to your benefits plans when you sign an extension!

4 Basic Types of QLEs

The most common examples include:

  1. Loss of health coverage

  2. Changes in household

  3. Changes in residence

  4. Other qualifying events

View the full list at HealthCare.gov.

QLE Effective Date

  • Effective date of Insurance becomes the QLE date. (i.e., If you get married on July 5, your change/enrollment is effective July 5th.)

Filing your life event in ADP

  • Navigate to Myself > Benefits to activate a life event for add/drop dependents:

If dropping a dependent: navigate to the dependent and select the actions next to the dependent to trigger the drop coverage life event.

Required Documents

Below are examples of qualifying life events and supporting documents.

Required Documents

Below are examples of qualifying life events and supporting documents.

QLE Category

Type of Change

Supporting Documents

Legal Marital Status

Marriage

None



Divorce or annulment

Divorce decree/court ruling for annulment



Legal separation

Court order of legal separation



Death of spouse

Death certificate

Number of Dependents

Birth

Birth certificate



Death

Death certificate



Adoption/placement for adoption

Court order for adoption /placement for adoption



Child aging off parent's plan (age 26)

COBRA letter, documentation from carrier, documentation from parent's employer on company letterhead

Employment Status of Employee or Spouse

Loss of employment

Termination documents on company letterhead, COBRA letter, or unemployment application



Start of employment

Employer documentation on company letterhead with employment start date



Change in worksite

Employer documentation on company letterhead showing change and impact on eligibility



Leave of absence

Employer documentation on company letterhead stating employee has started or returned from leave

Gain/Lose Eligibility for Other Group Coverage (HIPAA special enrollment)

Group health plan

Documentation from plan or carrier regarding change in eligibility with effective date

Employment status of Employee or Spouse

Loss of employment

Termination documents on company letterhead, COBRA letter, or unemployment application



Start of employment

Employer documentation on company letterhead with employment start date



Change in worksite

Employer documentation on company letterhead showing change and impact on eligibility



Leave of absence

Employer documentation on company letterhead stating employee has begun or returned from leave

Place of Residence

Permanent change in residence of employee, spouse, or dependent that affects eligibility

Employer documentation on company letterhead on how residence change affects employee (ie availability of different health plans).

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