Qualified Life Events | QLE

The full list of all documents you can use to enroll in State benefits.

• Supporting Documentation List

Here is the full chart of all possible QLE changes. 

• QLE and Mid-Year Changes Chart

Premiums - If premiums change, new amounts will be deducted beginning the pay period following the effective date of your coverage. No refunds of premiums for retroactive termination will be provided if notification of QLE is received beyond 31 days of the event.

• Duplicate/dual enrollment in State plans is prohibited and will be terminated without refunds for the premiums paid.
• For spouses who are State and/or 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, they 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).

Changes to Make Anytime

Update Personal Information

• You may need to change the contact information for you, your spouse, and your dependents.
• To make changes, visit hrsystems.azdoa.gov> YES portal> Bookmarks> Your Employee Services> Personal Information.
• Changes are effective immediately.

Beneficiary Changes

You may choose to change or update beneficiaries for your retirement plan, life insurance, and/or deferred compensation programs.

Changes can be made at any time and are effective immediately after submitting the applicable change of beneficiary forms.

• Life Insurance: hrsystems.azdoa.gov> YES Portal> Bookmarks> Your Employee Services> Benefits> Beneficiary. 
• Retirement Plan: Login to the Arizona State Retirement System at azasrs.gov and update your beneficiaries on the home page.
• Deferred Compensation: Complete the beneficiary forms for your 403(b) and 457 plans on the Nationwide AZ Smart Save site - arizonadc.com 

Direct Deposit

• You may choose to change the account to which you are directly depositing your pay.
• To make changes, visit hrsystems.azdoa.gov> Y.E.S. portal> Bookmarks> Your Employee Services> Pay> Direct Deposit.
• Changes are effective within two to three paychecks.

Tax Withholding

• You may choose to review your federal and state tax withholdings and make any necessary adjustments.
• To view your current withholding, visit hrsystems.azdoa.gov> Y.E.S. portal> Bookmarks> Your Employee Services> Pay> Tax Withholding.
• To make changes, submit a new IRS W-4 and/or Arizona A-4 to your payroll office.
• Tax withholding changes can be made at any time and are effective in the next available paycheck.

Educational Savings Plans - AZ529

• You may choose to consider participating in a Higher Education College Savings Plan.
• Visit the AZ529.gov website for more information about participating in a 529 college savings plan. After you establish an account, you may set up direct deposits at hrsystems.azdoa.gov > Y.E.S. portal> Bookmarks> Your Employee Services> Pay> Direct Deposit. 
• You can begin direct deposits from your paycheck at any time.

Changes During QLE Benefits Enrollment - 31-Day Deadline from Date of Event

Medical, Dental, Vision

• If you are enrolled in health insurance, you may add your newly eligible child to your current plans. 
• You have 31 days to add your child to your medical, dental, and or vision coverage on hrsystems.azdoa.gov> YES portal> Life Events. In the Life Events Form Section, click "Birth." See the Birth Qualified Life Event User Guide for instructions.
• Newborns—Please note that newborn children are covered under their mother’s insurance only for the first 31 days of their lives. This time includes several doctor's appointments, so it seems that the infant is "automatically" covered. It is not. After 31 days, they must be enrolled under their own name, or they will not be covered.
• Supporting Documentation: Birth certificate. You do not need to wait for a birth certificate. You may temporarily use a crib card or hospital letter until you receive one.
• When you enroll your child, you are requested to provide his or her Social Security number. If you have not yet obtained a Social Security number for your child, you may enroll your child without the number and submit it to AODA Benefits when you have it. 
• Coverage begins on the date of birth after all supporting documents are received.

Flexible Spending Account (FSA) 

You may choose to enroll or change your contributions.

• Medical FSA: Use pre-tax dollars to pay for qualified medical expenses. Learn more on the FSA page.
• Child/Adult Daycare FSA: Use pre-tax dollars to pay for qualified dependent care expenses. Learn more on the FSA page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of birth after all supporting documents are received.

Short-Term Disability Insurance (STD)

• You may choose to add short-term disability coverage. 
• The STD benefits from MetLife offer the ability to replace a portion of your earnings if you are sick or hurt and cannot work. Learn more on the Disability Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of birth after all supporting documents are received.

Life Insurance

• You may choose to purchase life insurance for your child.
• The supplemental voluntary life insurance benefits from Securian allow you to purchase life insurance for all your dependents on one policy. Learn more on the Life Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of birth after all supporting documents are received.

Additional Changes to Remember

• See " Anytime Changes " above to update personal contact information, beneficiaries, tax withholding, direct deposit, and a college savings plan with AZ529.

Additional Assistance

Childcare

• You may need to secure child care for your child. 
• Please visit the Employee Assistance Program for information regarding childcare provider referrals. Please note: Individual childcare facilities maintain availability.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• Access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter WEB ID: HN8876C to register.

Employee Assistance Program - Adjusting to Parenting

• While adding a new child to your family is a happy event, you may benefit from assistance with making the adjustment.
• Please visit the Employee Assistance Program for information regarding free, confidential counseling and referral services, including childcare providers and parenting resources.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• You can access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter company code HN8876C to register. You may call or visit the website 24/7.

Changes During Benefits Enrollment - 31-Day Deadline from Date of Event

Medical, Dental, Vision

• If you are enrolled in health insurance, you may add your newly eligible adopted child to your current plans. 
• You have 31 days to add your child to your medical, dental, and or vision coverage on hrsystems.azdoa.gov> YES portal> Life Events. In the Life Events Form Section, click "Adoption." See the Adoption Qualified Life Event User Guide for instructions.
• Supporting Documentation: Birth certificate and adoption certificate. Note: You do not need to wait for a birth certificate. You may use a crib card or hospital letter.
• Your child’s Social Security number is requested when you enroll your child. If you have not yet obtained a Social Security number for your child, you may enroll your child without the number and submit it to AODA Benefits when you have it. 
• Coverage begins on the date of adoption after all supporting documents are received. 

Flexible Spending Account (FSA) 

You may choose to enroll or change your contributions.

• Medical FSA: Use pre-tax dollars to pay for qualified medical expenses. Learn more on the FSA page.
• Child/Adult Daycare FSA: Use pre-tax dollars to pay for qualified dependent care expenses. Learn more on the FSA page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of adoption after all supporting documents are received.

Short-Term Disability Insurance (STD)

• You may choose to add short-term disability coverage. 
• The STD benefits from MetLife offer the ability to replace a portion of your earnings if you are sick or hurt and cannot work. Learn more on the Disability Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of adoption after all supporting documents are received.

Life Insurance

• You may choose to purchase life insurance for your child.
• The supplemental voluntary life insurance benefits from Securian offers the ability to purchase life insurance for all your dependents on one policy. Learn more on the Life Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of adoption after all supporting documents are received.

Additional Changes to Remember

• To update personal contact information, beneficiaries, tax withholding, and direct deposit, and a college savings plan with AZ529, see "Anytime Changes" above.

Additional Assistance

Childcare

• You may need to secure child care for your child. 
• Please visit the Employee Assistance Program for information regarding childcare provider referrals. Please note: The availability of childcare facilities is maintained by individual facilities.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• Access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter WEB ID: HN8876C to register.

Employee Assistance Program - Adjusting to Parenting

• While adding a new child to your family is a happy event, you may benefit from assistance with making the adjustment.
• Please visit the Employee Assistance Program for information regarding free, confidential counseling and referral services, including childcare providers and parenting resources.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• Access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter company code HN8876C to register. You may call or visit the website 24/7.

Changes During QLE Benefits Enrollment - 31-Day Deadline from Date of Event

Medical, Dental, Vision

• If you are enrolled in health insurance, you may add your spouse (and stepchildren, if applicable) to your current plans. If you are joining your spouse's plan, you may remove your coverage on the ADOA plan. 
  • The changes you can make include: 
    • Tier structure (i.e. EE + Spouse to Family)
    • Plan type (i.e. Triple Choice Plan to High Deductible Health Plan, etc.)
    • Network vendor (i.e. BCBSAZ to UHC, however, your deductibles will not transfer between vendors)
• You have 31 days to add your spouse and stepchildren to your medical, dental, and or vision coverage on hrsystems.azdoa.gov> YES portal> Life Events. In the Life Events Form Section, click "Marriage." See the Marriage Qualified Life Event User Guide for instructions.
• Electing coverage: Coverage begins the first day of the next month following receipt of required documentation.
• Removing coverage: Coverage is terminated on the last day of the pay period in which the Member makes the last contribution.
• Supporting Documentation: For your spouse, a marriage certificate. For your stepchildren, a birth certificate and a marriage certificate. Supporting documentation list.
• Name Change: Only update if you have legally changed it with the Social Security Administration (SSA). If you have not completed the SSA process, leave your name unchanged, but continue with your benefits changes now so you meet the 31-day deadline. After completing the SSA process, contact your HR office to have your name updated in YES. Your status and personal contact info are updated immediately in YES when you make the change. Your work email address will be updated when you submit your legal name change to your HR office.

Flexible Spending Account (FSA) 

You may choose to enroll or change your contributions.

• Medical FSA: Use pre-tax dollars to pay for qualified medical expenses. Learn more on the FSA page.
• Child/Adult Daycare FSA: Use pre-tax dollars to pay for qualified dependent care expenses. Learn more on the FSA page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Electing Coverage: Coverage begins the first day of the next month following receipt of supporting documentation.
• Removing Coverage: Termination of coverage is effective the last day of the pay period in which the Member makes the last contribution.

Short-Term Disability Insurance (STD)

• You may choose to add short-term disability coverage. 
• The STD benefits from MetLife offer the ability to replace a portion of your earnings if you are sick or hurt and cannot work. Learn more on the Disability Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins the first day of the next month following receipt of supporting documentation.

Life Insurance

• You may choose to purchase life insurance for your child.
• The supplemental voluntary life insurance benefits from Securian offers the ability to purchase life insurance for all your dependents on one policy. Learn more on the Life Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Electing Coverage: Coverage begins the first day of the next month following receipt of supporting documentation.
• Removing Coverage: Termination of coverage is effective the last day of the pay period in which the Member makes the last contribution.

Additional Changes to Remember

• To update personal contact information, beneficiaries, tax withholding, and direct deposit, see "Anytime Changes" above.

Additional Assistance

Childcare

• You may need to secure childcare for your stepchild. 
• Please visit the Employee Assistance Program for information regarding childcare provider referrals. Please note: The availability of childcare facilities is maintained by individual facilities.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• Access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter WEB ID: HN8876C to register.

Employee Assistance Program - Adjusting to Marriage

• While marriage is a happy event, you may benefit from assistance with making the adjustment.
• Please visit the Employee Assistance Program for information regarding free, confidential counseling and referral services, including relationship resources and childcare providers.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• Access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter company code HN8876C to register. You may call or visit the website 24/7.

Changes During QLE Benefits Enrollment - 31-Day Deadline from Date of Event

Medical, Dental, Vision

• Your former spouse and your stepchildren are no longer eligible dependents for medical and dental coverage as of the first of the month following the divorce. They must be removed from the plan regardless of a court order to continue their coverage. Coverage must be obtained elsewhere. COBRA benefits are an option, and a packet will be sent to your ex-spouse upon disenrollment. (If you have adopted a stepchild, they may remain on the plan.)
• If you declined benefits and your divorce results in you losing coverage under your ex-spouse’s health insurance, see the Divorce, Legal Separation, and Annulment Process.
• You have 31 days following your divorce to remove your former spouse and stepchildren from coverage on hrsystems.azdoa.gov> YES portal> Bookmarks> Your Employee Services> Life Events. In the Life Events Forms section, click "Divorce." For instructions, see the Divorce Qualified Life Event User Guide. 
• Supporting Documentation: Divorce decree.
• Name Change: Only update if you have legally changed it with the Social Security Administration (SSA). If you have not completed the SSA process, leave your name unchanged, but continue with your benefits changes now so you meet the 31-day deadline. After completing the SSA process, contact your HR office to have your name updated in YES. Your status and personal contact info are updated immediately in YES when you make the change. Your work email address will be updated when you submit your legal name change to your HR office.
• Coverage terminates on the date of the divorce after supporting documentation is received. Premiums are not refunded. If premiums change, new amounts will be deducted beginning the pay period following receipt of supporting documents.

Flexible Spending Account (FSA) 

You may choose to enroll or change your contributions.

• Medical FSA: Use pre-tax dollars to pay for qualified medical expenses. Learn more on the FSA page.
• Child/Adult Daycare FSA: Use pre-tax dollars to pay for qualified dependent care expenses. Learn more on the FSA page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of birth, after all supporting documents are received.

Short-Term Disability Insurance (STD)

• You may choose to add short-term disability coverage. 
• The STD benefits from MetLife offer the ability to replace a portion of your earnings if you are sick or hurt and cannot work. Learn more on the Disability Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage is effective on the date of the divorce, after all supporting documents are received.

Life Insurance

• You may choose to remove Dependent Life insurance coverage for your former spouse and stepchildren.
• Elect supplemental life insurance up to $20K or reduce supplemental life to pre-tax amount of $35K. Elect dependent life insurance, any amount or decline dependent life if spouse is the only eligible dependent.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Termination of coverage is effective the date of the divorce, after supporting documentation is received. Premiums are not refunded. If there is a change in premiums, new amounts will be deducted beginning the pay period following receipt of documentation.

Additional Changes to Remember

• To update personal contact information, beneficiaries, tax withholding, and direct deposit, see "Anytime Changes" above.

Additional Assistance

Employee Assistance Program - Adjusting to Divorce

• If a change in marital status is causing you stress on or off the job, you may benefit from assistance with making the adjustment.
• Please visit the Employee Assistance Program for information regarding free, confidential counseling and referral services. Topics include relationships, custody, legal information, and more.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families.
• Access these services by calling 1-877-327-2362 or visiting guidanceresources.com. Enter company code HN8876C to register. You may call or visit the website 24/7.

Changes During QLE Benefits Enrollment - 31-Day Deadline from Date of Event

Medical, Dental, Vision

• Your spouse is considered eligible to continue participation in the plans because you are still married.  
  • If the notice of legal separation requires your spouse's healthcare coverage to continue, you cannot remove coverage until the divorce is finalized. 
  • If the notice of legal separation does not require your spouse's healthcare coverage to continue, you may choose to remove your spouse from coverage before the divorce is finalized. 
• If you declined benefits and your divorce results in you losing coverage under your ex-spouse’s health insurance, see the Divorce, Legal Separation, and Annulment Process.
• You have 31 days following your divorce to remove your former spouse and stepchildren from coverage on hrsystems.azdoa.gov> YES portal> Bookmarks> Your Employee Services> Life Events. In the Life Events Forms section, click "Legal Separation." For instructions, see the Legal Separation Qualified Life Event User Guide. 
• Supporting Documentation: Legal separation decree.
• Name Change: Only update if you have legally changed it with the Social Security Administration (SSA). If you have not completed the SSA process, leave your name unchanged, but continue with your benefits changes now so you meet the 31-day deadline. After completing the SSA process, contact your HR office to have your name updated in YES. Your status and personal contact info are updated immediately in YES when you make the change. Your work email address will be updated when you submit your legal name change to your HR office.
• Coverage ends at the end of the pay period following the date of legal separation after all supporting documentation is submitted. If there is a change in premiums, new amounts will be deducted beginning the pay period following receipt of documentation.

Flexible Spending Account (FSA) 

You may choose to enroll or change your contributions.

• Medical FSA: Use pre-tax dollars to pay for qualified medical expenses. Learn more on the FSA page.
• Child/Adult Daycare FSA: Use pre-tax dollars to pay for qualified dependent care expenses. Learn more on the FSA page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of the separation after all supporting documents are received.

Short-Term Disability Insurance (STD)

• You may choose to add short-term disability coverage. 
• The STD benefits from MetLife offer the ability to replace a portion of your earnings if you are sick or hurt and cannot work. Learn more on the Disability Insurance page.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• Coverage begins on the date of the separation after all supporting documents are received.

Life Insurance

• You may choose to remove Dependent Life insurance coverage for your former spouse and stepchildren.
• Elect supplemental life insurance up to $20K or reduce supplemental life to a pre-tax amount of $35K. Elect dependent life insurance, any amount, or decline dependent life if your spouse is the only eligible dependent.
• Make changes during the benefits enrollment process shown above for "Medical, Dental, Vision."
• The coverage will terminate effective the date of the separation after supporting documentation is received. Premiums are not refunded. If premiums change, new amounts will be deducted beginning the pay period following receipt of documentation.

Additional Changes to Remember

• To update personal contact information, beneficiaries, tax withholding, and direct deposit, see "Anytime Changes" above.

Additional Assistance

Employee Assistance Program - Adjusting to Divorce

• If a change in marital status is causing you stress on or off the job, you may benefit from assistance with making the adjustment.
• Please visit the Employee Assistance Program for information regarding free, confidential counseling and referral services. Topics include relationships, custody, legal information, and more.
• The Employee Assistance Program (EAP) from CompPsych is available to all State employees and their families. 
• You can access these services by calling 1-877-327-2362 or visiting guidanceresources.com. To register, enter the company code HN8876C. You may call or visit the website 24/7.

Please refer to the Age 26 Dependent Termination Process document for full details.

If your employer 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 your dependents may extend coverage per 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

For the death of a State employee 

• Please refer to the State Employee Information Organizer with important information in the event of death while employed with the State. Benefits are outlined on p. 7. 
• For more information, please contact a Benefit Options representative by phone 602-542-5008, toll-free 1-800-304-3687, by email at [email protected].

Death of a spouse or dependent

Please submit the following forms to [email protected]

• Active Enrollment Form is found on the Forms page.
• Death certificate

If enrolled in the DHMO dental plan, you may change to the PPO dental plan if moving out of the coverage area. NOTE: Not applicable to medical and vision coverage since plans are nationwide unless the situation involves moving in or out of the country. To see changes you can make, please refer to the QLE and Mid-Year Changes Chart.

Please submit the following forms to [email protected]

• Active Enrollment Form is found on the Forms page.
• Required Supporting Documentation

Loss of Children’s Health Insurance Program (CHIP) or Medicaid Coverage is a HIPAA Special Enrollment. You may elect or decline any and/or all coverage.

Changes must be made within 60 days. Coverage begins the first day of the next month following receipt of documentation.  

Please submit the following forms to [email protected]

• Active Enrollment Form is found on the Forms page.
• Required Supporting Documentation

Changes affecting benefit eligibility for you, your spouse, and/or your 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.

To see changes you can make, please refer to pg. 6-7 and pg. 10 of the QLE and Mid-Year Changes Chart

Please submit the following forms to [email protected]

• Active Enrollment Form is found on the Forms page.
• Required Supporting Documentation

Please refer to the QLE and Mid-Year Changes Chart for your event. 

For more information, please contact a Benefit Options representative by phone at 602-542-5008, toll-free at 1-800-304-3687, by email at [email protected].