Qualified Life Event | QLE
QUALIFIED LIFE EVENT (QLE) DEFINITIONS
Qualified Life Events (QLEs) include but are not limited to the following:
- Marital status: marriage, divorce, legal separation, annulment, death of a spouse
- Your former spouse must be removed from the plans regardless of a court order to continue their coverage.
- Divorce, Legal Separation and Annulment Process
- Dependent status: birth, adoption, placement for adoption, death, marriage or dependent eligibility due to age
- Newborn Coverage - see below
- Age 26 Dependent Termination Process
- Eligibility status: becoming eligible for Medicare
- Residence status: resulting in different plan options available
- Employment status or work schedule: affecting benefit eligibility for you, your spouse, and/or dependent.
Can include:- LWOP - leave without pay
- Returning from an Approved Leave: If coverage was modified at the initiation of leave, you must elect your previous level of medical, dental and/or vision coverage.
Premiums must be current or you may not re-elect any coverage until the next open enrollment period. - Return to Work Retirees - see the information listed below.
- Additional QLEs - for a full list see the QLE & Mid-Year Changes Chart
NEWBORN COVERAGE - 31 DAY DEADLINE
- Your newborn is ONLY covered under your insurance for the first 31 days after birth.
- Before the 31st day, you must ENROLL your newborn as a dependent.
- Deadline: If you miss the 31-day requirement, your newborn will not have coverage. You will have to wait to enroll until the next Open Enrollment or Qualified Life Event.
- Note: You do not have to wait for a birth certificate. You may enroll your child with a crib card or hospital verification letter.
- Refer to How to Change Benefits for a Qualified Life Event (QLE) below.
DUPLICATE/DUAL ENROLLMENT - BOTH SPOUSES STATE EMPLOYEES
Duplicate/dual enrollment in State plans is prohibited and will be terminated with no refunds for the premiums paid. For spouses who are State and/or a State University employees and/or retirees, these rules apply:
- You cannot enroll each other as dependents, nor have your children enrolled twice.
- One spouse may elect coverage for the entire family, or each spouse may elect their own individual coverage.
- Dependent children can be on one spouse's policy or divided between spouses.
- If your child is a State and/or State University employee, he/she cannot be enrolled as a single subscriber in a State plan and as a dependent on your policy.
- You cannot enroll simultaneously as a single subscriber in the retiree medical, dental, and/or vision plans for the Arizona Department of Administration (ADOA) AND the Arizona State Retirement System (ASRS).
TERMINATION OF COVERAGE - CONTINUATION OF BENEFITS
If your benefits are terminated, you may have options to continue coverage:
- Medical/Dental/Vision
- If you experience a loss of coverage due to termination of employment or a QLE, you and or your dependents may extend coverage in accordance with COBRA (Consolidated Omnibus Budget Reconciliation Act).
- The Benefits Services Division will determine eligibility.
- Learn more on our COBRA page.
- Life Insurance
- You and/or your dependents may have the option to convert your life insurance coverage.
- Contact our carrier, Securian | 833-745-5517 | lifebenefits.com/plandesign/Arizona | Determine your life insurance needs: Benefits Scout
WHEN YOU CAN CHANGE YOUR BENEFITS
You may change your benefit elections under the following conditions:
- Open Enrollment - annually in the fall
- Qualified Life Event (QLE) - within the deadline listed below
- The changes you can make are dependent on the type of QLE. See the QLE and Mid-Year Changes Chart for full details.
- Deadline: All forms and required documentation must be submitted within 31 days of the QLE, as outlined below under How to Change Benefits for a Qualified Life Event (QLE).
- If you have not experienced a QLE as defined above, you must wait until the next annual open enrollment period to make changes.
- Year-Round Benefit Changes
- Decline Short-Term Disability coverage
- Decrease Supplemental Life in increments of $5,000 to pre-tax amount of $35K, if applicable
- Decline Dependent Life
- Life Insurance beneficiary changes
- Adjust Health Savings Account (HSA) contributions
- Adjust Flexible Spending Account contributions - during COVID-19 National Emergency only
HOW TO CHANGE BENEFITS FOR A QUALIFIED LIFE EVENT (QLE)
- Gather: All required documentation as listed on the QLE and Mid-Year Changes Chart
- Fill out: Declaration for Change Form
- Fill out: Active Benefits Enrollment Form - 2021
- Deadline: Submit both forms WITH required documentation within 31 days of the QLE.
- Any missing information or supporting documents will delay processing, see below
- Email: [email protected]
- FAX: 602-542-4744
SUPPORTING DOCUMENTATION REQUIREMENTS
- Supporting documentation must be provided when adding/removing a spouse or dependent.
- See the QLE and Mid-Year Changes Chart for the documents required.
- Note: You do not need a birth certificate to enroll a newborn. You may use a crib card or hospital verification letter. See "Newborn Coverage" above.
- Deadline: All forms and required documentation must be submitted within 31 days, or loss of enrollment will result.