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Qualified Life Events | Retirees

WHEN YOU CAN CHANGE YOUR BENEFITS

You may change your benefit elections under the following conditions:

  1. Open Enrollment - annually in the fall
  2. Qualified Life Event (QLE) - within the specified time period 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 below, you must wait until the next annual open enrollment period to make changes. 

HOW TO CHANGE BENEFITS FOR A QUALIFIED LIFE EVENT (QLE)

  1. Gather: All required documentation as listed on the QLE and Mid-Year Changes Chart.
  2. Fill out: Retiree Benefits Enrollment Form 2020
  3. Deadline: Submit form WITH required documentation within 31 days of the QLE. 
  • Any missing information or supporting documents will delay processing.
  • Email: [email protected]
  • FAX: 602-542-4744
     

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
    • 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
    • Return to Work Retirees - see the information listed below.
  • Additional QLEs - see the QLE and Mid-Year Changes Chart for a full list.

SUPPORTING DOCUMENTATION REQUIREMENTS

  • Supporting documentation must be provided when adding/removing a spouse or dependent.
  • Deadline: All forms and required documentation must be submitted within 31 days, or loss of enrollment will result. 
  • See the QLE and Mid-Year Changes Chart for the documents required.

DUPLICATE/DUAL COVERAGE RULES - BOTH SPOUSES STATE EMPLOYEES 

Duplicate or 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).

 

RETIREES/LTD

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  • Understanding Your Premium
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ADOA | Benefit Services Division | Benefit Options
100 N. 15th Ave., Ste. 260
Phoenix, AZ 85007
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Phone: 602-542-5008
Fax: 602-542-4744
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