Qualified Life Events

The health and welfare elections you make are for the entire calendar year and generally cannot be changed outside of Annual Open Enrollment. However, if you have a Qualified Life Event as defined by the IRS, you will be able to make benefit changes that are consistent with your life event.

Qualified Life Events include:

  • Marriage, divorce or newly eligible same or opposite sex domestic partner
  • Birth or adoption of a child
  • Death of your spouse/same or opposite sex domestic partner or dependent child
  • A dependent becoming ineligible for coverage
  • Your spouse/same or opposite sex domestic partner gaining or losing coverage at his/her job
  • You transferring between full-time and part-time status
  • You moving from a non-benefit eligible position to a benefit eligible position

Benefit changes must be consistent with your event. For example, if you have a baby, you may add the baby to your medical coverage. You cannot, however, drop dental coverage for other family members at this time.

Steps to make a mid-year change due to a Qualifying Life Event:

You must complete the steps below within 30 calendar days* of the Qualified Life Event to make changes to your benefit elections. 

  1. Enroll in Health and Welfare benefits, and choose the life event that occurred in order to enter the EasyEnroll system.
  2. Provide supporting documentation of the life event within 30 calendar days of the life event to [email protected].

*NOTE: Birth/adoptions of a child, divorce and/or change in eligibility for Medicaid/CHIP are given 60 calendar days to make changes and submit supporting documentation. For birth/adoption of a child events: If you make changes to your benefits and submit your supporting documentation within 60 calendar days of the birth/adoption event, benefit changes will be effective on the date of birth/adoption; however, if benefit changes and supporting documentation are submitted after 60 calendar days, then benefit changes will be effective on the first of the month following receipt of supporting documentation.

Effective date of changes:

Changes made to your benefits due to a Qualified Life Event are effective the first of the month following receipt of supporting documentation and your online changes are completed within 30 calendar days.

If you or your dependent are losing/gaining health coverage as of the last day of a month, please be sure to send GW Benefits the supporting documentation in advance of the loss or gain in coverage date to ensure there is no lapse or overlap in coverage. For example, if other coverage is ending 11/30 and you wish to have GW coverage begin 12/1, you must provide your supporting documentation to GW Benefits no later than 11/30. You then will have 30 calendar days from the life event date to enter your online changes. The coverage changes, if approved, will be retro to 12/1. 

Here is a chart showing when your coverage will be effective based on when you send the Benefits office a copy of the supporting documentation. In this situation, documentation proving the date the coverage was lost is the supporting documentation that you will need to submit to the benefits office:

If all required paperwork is received by:

The change will be effective on:

30-Nov

1-Dec

10-Dec

1-Jan

10-Jan

You have missed the 30 calendar day deadline and may not make changes to your coverage

Examples of Supporting Documentation:

Life Event

Supporting Documentation that needs to be submitted to the benefits office for review

Marriage

Copy of marriage certificate

Birth/Adoption

Copy of birth certificate or adoption papers

Loss or gain of coverage

Copy of documentation proving the date the coverage was lost or gained (example: Letter from employer or insurance company where coverage was lost or gained)

Newly eligible same or opposite sex domestic partner

Fill out the declaration of domestic partnership form located in the forms section on the benefits website and provide 3 required documents listed in the form