What is a Qualified Life Event?

Most individuals go through a number of life events that affect their health benefit needs and the choices they make. There are several important federal laws that affect their benefits under a job-based health plan. While employees, in general, are only allowed to change their  benefits elections during the open enrollment period, certain life events provide an exception or a Qualified Life Event. Those life events allow employees to change their benefits elections in the middle of the plan year as long as certain requirements are met. The following are examples of types of life events that may allow an employee to change their benefit elections during a plan year:

  •  Birth/Adoption
  •  Change in Insurance Coverage
  •  Change of Address
  •  Change in Employment Status
  •  Death in the Family
  •  Dependent Child Reaches Limiting Age
  •  Divorce/Annulment
  •  FMLA-related Leave
  •  Legal Separation
  •  Marriage
  •  Spouse Loss of Other Coverage

The provided infographic can be used to help educate employees on how benefits can be amended mid-year through qualified life events.

DISCLOSURE

The information provided herein is intended solely for the use of our clients. You may not display, reproduce, copy, modify, license, sell or disseminate in any manner any information included herein, without the express permission of the Publisher or Publishers of articles within.

The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.