The health and welfare elections you make apply to an entire calendar year and generally cannot be changed outside of the annual open enrollment period, as per IRS rules. However, if you experience a Qualified Life Event (QLE), you will be able to make benefit changes that are consistent with your life event. With baby and wedding season upon us, we thought it would be helpful to provide a quick refresher on what constitutes a QLE and how it impacts your benefits. Check out these frequently asked questions.
What is considered a QLE?
As defined by the IRS, QLEs include:
- Marriage, divorce or newly eligible same- or opposite-sex domestic partner
- Birth or adoption of a child
- Death of a spouse, same- or opposite-sex domestic partner or dependent child
- Dependent becoming ineligible for coverage
- Spouse or same- or opposite-sex domestic partner gaining or losing coverage at his or her job
- Transfer between full-time and part-time status
- Move from a non-benefits eligible position to a benefits eligible position
How do I make a mid-year benefit change due to a QLE?
It is first important to note that any benefit changes you make due to a QLE must be consistent with that event. For instance, giving birth authorizes you to add your new baby to your medical coverage; it does not, however, allow you to drop dental coverage for other family members. Any desired benefit changes that are not consistent with a QLE cannot be made until the next open enrollment period.
To make a mid-year benefit change due to a QLE, you must complete the steps below within 30 calendar days of the QLE (birth and adoption of a child events must be completed within 60 calendar days):
- Email all supporting documentation for the life event to the GW Benefits office (benefits@gwu.edu).
- Enroll in Health and Welfare benefits via EasyEnroll (go.gwu.edu/easyenroll) – select the appropriate life event among those listed in order to enter the EasyEnroll system.
What is “supporting documentation?”
Examples of supporting documentation based on life event are given below:
- Marriage: copy of a marriage certificate.
- Birth or adoption of a child: copy of birth certificate or adoption papers.
- Loss or gain of coverage: copy of documentation proving the date the coverage was lost or gained (such as a letter from an employer or insurance company where coverage was lost or gained).
- Newly eligible same– or opposite-sex domestic partner: completed Declaration of Domestic Partnership form; you must also provide three of the required documents listed on the form.
When do benefit changes become effective?
Most benefit changes for QLEs become effective on the first day of the month following receipt of supporting documentation. For birth or adoption of a child, the effective date of coverage is the date of birth or adoption. Please note: documentation must be submitted within the required time frame in order to be approved.
Learn more at www.benefits.gwu.edu/qualified-life-events.
