Change in Status Events

Overview

Your benefit elections are part of an IRS Section 125 plan, which determines what changes are allowed outside the normal enrollment period. Only changes consistent with and on account of your qualifying life event will be permitted, for example, you may add a newborn to coverage due to the life event of a “birth,” but you may not cancel health coverage. You must request changes to your benefit elections within 30 days of the event. Please note that documentation is required when adding dependents to coverage and to verify the qualifying life event. Documentation must be received within 31 days of the event date in order for the coverage/change to be allowed. Changes will be effective the date of the event. Premiums will not be prorated if an employee changes their coverage elections or terminates coverage on a day other than the first day of the pay period.

Evidence of insurability will be required to add or increase life insurance, or to enroll in short-term and long-term disability coverage outside the initial enrollment period. Evidence of insurability is also required when requesting life insurance for an amount that is above the guaranteed issue amount.

If you need to add a dependent to coverage, cancel or make changes to your benefits as a result of a life event, you will need to go to the enrollment site or call the Benefits Call Center at 1-844-851-5419.

Below is a brief list of common events and what your options are if you experience one of these events. You can see more events on the enrollment site.

Event Permitted Elections/Changes
Birth, Adoption or Guardianship
  • Enroll in or change medical, dental and/or vision
  • Enroll in or increase employee, spouse life and/or child life coverage
  • Enroll in short-term and/or long-term disability
  • Enroll in Dependent Care FSA (for reimbursement of daycare expenses)
  • Enroll in Healthcare FSA (available only if enrolled in either the $900 or $1,500 deductible medical plan)
  • Add spouse/domestic partner and/or dependent child(ren)
Getting Married/ Domestic Partnership Begins
  • Cancel medical, dental and/or vision*
  • Enroll in short-term disability and/or long-term disability
  • Enroll in medical, dental and/or vision
  • Increase employee, spouse, child life and/or AD&D coverage
  • Enroll in or increase Healthcare FSA contribution (available only if enrolled in either the $900 or $1,500 deductible medical plan)
  • Enroll in, increase or decrease* Dependent Care FSA contribution
  • Add spouse/domestic partner and/or child(ren)
Getting Divorced (Legally Separated, Ending a Partnership)
  • Cancel spouse life and/or child life
  • Cancel short-term and/or long-term disability
  • Enroll in or decrease Healthcare FSA or Dependent Care FSA contribution
  • Change medical, dental and/or vision
  • Decrease employee life and AD&D coverage
  • Decrease Healthcare FSA and/or Dependent Care FSA contribution
  • Add dependent child(ren)
  • May drop dependent child(ren); MUST drop spouse/domestic partner, and dependent child(ren) of domestic partner and stepchildren
Going on Unpaid Leave of Absence
  • Cancel medical*
  • Drop spouse/domestic partner and/or child(ren)
Returning to Work from Unpaid Leave of Absence
  • Enroll in medical, dental and/or vision
  • Add spouse/domestic partner or child(ren)
  • Increase or decrease healthcare and/or Dependent Care FSA* contribution
Termination of Employment/Retirement
  • All coverages terminate the last day of the month in which the termination or retirement occurs
  • If re-employed within 30 days, all coverages will be automatically reinstated; employee must contact Mercer Marketplace to cancel any unwanted coverage within 30 days of their return to work
Gain of Other Coverage
  • Cancel medical, dental and/or vision*
  • Cancel or decrease employee, spouse, child life and/or voluntary AD&D
  • Cancel short-term and/or long-term disability
  • Drop spouse/domestic partner and/or dependent children
  • Increase, decrease or cancel Dependent Care FSA* contribution
Loss of Employee’s (or Dependent’s) Other Coverage
  • Enroll in or make changes to medical, dental and/or vision
  • Enroll in or increase employee, spouse, child life and/or voluntary AD&D
  • Enroll in short-term or long-term disability
  • Enroll, increase or decrease Dependent Care FSA contribution
  • Add spouse/domestic partner and/or dependent children
Loss of Medicaid or CHIP Coverage***
  • Enroll in or make changes to medical coverage
  • Add spouse/domestic partner and/or dependent children
Dependent Turns 26
  • Your dependent child will have all coverages, including child life, automatically terminated effective the last day of the month in which they turn age 26
  • Decrease Healthcare FSA and/or Dependent Care FSA (permitted only if child is disabled) contribution
Qualified Medical Support Order
  • Your dependent child(ren) will automatically be added to the type of coverage specified in the order, effective the date indicated in the order; this election can only be changed by a future court order terminating the coverage
Now Eligible for Premium Assistance Through Public Marketplace/Exchange
  • Cancel medical coverage*
  • Drop spouse/domestic partner and/or dependent child(ren)
Move/Change in Residence
  • Change medical, dental and/or vision coverage
Post‐Tax “Evergreen” Benefits
  • Changes to post-tax benefits are permitted by the IRS anytime during the plan year
  • Post-tax benefits include critical illness, hospital indemnity, accident protection, pet insurance, ID theft protection and legal services, as well as employee, spouse and child life insurance, short-term and long-term disability
* Coverage terminates or decreases at the end of the month following the event date.
** Employees can enroll in or make changes to a healthcare savings account (HSA) anytime during the plan year, without experiencing a qualifying life event.
*** Employees have 60 days in which to enroll due to this event
.