Qualifed Life Events | QLE
NEW - PROCESS QUALIFIED LIFE EVENTS ONLINE
The following events can be processed online: birth, adoption, marriage, divorce, and legal separation. See the "Qualified Life Event Processing" section below for more information.
INTRODUCTION
- All benefit elections made during your initial enrollment at retirement or annual open enrollment remain in effect during the entire Plan Year (January 1-December 31). However, there may be times when a retiree may experience a change in their family or work status that may allow for certain benefits to be changed mid-year.
- These changes are called qualified life events (QLE) and are governed by the IRS regulations of Section 125 Cafeteria Plans and HIPAA Special Enrollment Rights.
- There are several changes you can make depending upon your event.
- To begin: Select your Qualified Life Event from the list below and follow the instructions.
GUIDES AND RULES
- Supporting Documentation List
- QLE and Mid-Year Changes Chart
- Duplicate/Dual Enrollment for State/University Employees
- Premiums - If premiums change, new amounts will be deducted beginning the month 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.
QUALIFIED LIFE EVENTS
BIRTH
| Retiree Changes During Benefits Enrollment - 31 Day Deadline from Date of Event | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Medical, Dental, Vision | If you are enrolled in health insurance, you | 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. Supporting Documentation: Birth certificate. Note: You do not need to wait for a birth certificate -- a crib card or a hospital letter may be used. 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 ADOA Benefits when you have it. | Coverage begins on the date of birth after all supporting documents are received. Please note that newborn children are covered under their mother’s insurance only for the first 31 days of their life. After that time, they must be enrolled, or they will not be covered. |
| Changes to Make Anytime | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Beneficiary Changes | You may choose to change or update beneficiaries for your retirement plan and deferred compensation program. | Retirement Plan: Login to the Arizona State Retirement System 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. | Changes can be made at any time and are effective immediately following the submission of the applicable change of beneficiary forms. |
| Educational Savings Plans | 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. | You can begin direct deposits at any time. |
ADOPTION
| Retiree Changes During Benefits Enrollment - 31 Day Deadline from Date of Event | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| 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 "Adoption." See the Adoption Qualified Life Event User Guide for instructions. Supporting Documentation: Birth certificate and adoption certificate. Note: For a newborn, 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 ADOA Benefits when you have it. | Coverage begins on the date of adoption after all supporting documents are received. |
| Changes to Make Anytime | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Beneficiary Changes | You may choose to change or update beneficiaries for your retirement plan and deferred | Retirement Plan: Login to the Arizona State Retirement System 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. | Changes can be made at any time and are effective immediately following the submission of the applicable change of beneficiary forms. |
| Educational Savings Plans | 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. | You can begin deposits at any time. |
MARRIAGE
| Changes During Benefits Enrollment - 31 Day Deadline from Date of Event | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Medical, Dental, Vision | If you are enrolled in health insurance, you may add your spouse (and stepchildren, if applicable) your current plans. | You have 31 days to add your spouse 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 full instructions. Supporting Documentation: For a spouse, a marriage certificate. For stepchildren, a birth certificate and a marriage certificate. 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 ADOA Benefits to have your name updated in YES. | Electing coverage: Coverage begins the first day of the next month following receipt of required documentation. Removing coverage: Termination of coverage is effective the end of the month in which the Member pays a premium. |
| Changes to Make Anytime | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Update Personal Information | You may need to change contact information for you, your new spouse, and your dependents. | To make changes to your contact information, visit hrsystems.azdoa.gov > YES portal> Bookmarks> Your Employee Services> Personal Information. To make changes to contact information for a new spouse or dependents, contact ADOA Benefits. | Changes are effective immediately. |
| Beneficiary Changes | You may choose to change or update beneficiaries for your retirement plan, and deferred compensation program. | Retirement Plan: Login to the Arizona State Retirement System 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. | Changes are effective immediately following the submission of the applicable change of beneficiary forms. |
DIVORCE
| Changes During Benefits Enrollment - 31 Day Deadline from Date of Event | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| 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 document. | 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." See the Divorce Qualified Life Event User Guide for instructions. 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 to meet the 31-day deadline. After completing the SSA process, contact ADOA Benefits to have your name updated in YES. | Termination of coverage is effective on the date of the divorce, after receiving supporting documentation. Premiums are not refunded. If premiums change, new amounts will be billed beginning the first of the month following receipt of documentation. |
| Changes to Make Anytime | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Beneficiary Changes | You may choose to change or update beneficiaries for your retirement plan, and deferred compensation program. | Retirement Plan: Login to the Arizona State Retirement System 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. | Changes are effective immediately following the submission of the applicable change of beneficiary forms. |
| Update Personal Information | You may need to change the contact information for you, your ex-spouse, and your dependents. | To make changes to your contact information, visit hrsystems.azdoa.gov > YES portal> Bookmarks> Your Employee Services> Personal Information. To make changes to contact information for an ex-spouse or dependents, contact ADOA Benefits. | Changes are effective immediately. |
LEGAL SEPARATION
| Changes During Benefits Enrollment - 31 Day Deadline from Date of Event | |||
| Activity | What You Can Do | How You Do It | When Coverage is Available |
| Medical, Dental, Vision | Your spouse is eligible to continue participating in the plans because you are still married. If the notice of legal separation requires healthcare coverage to continue for your spouse, you cannot remove coverage until the divorce is finalized. If the notice of legal separation does not require healthcare coverage to continue for your spouse, then you may choose to remove your spouse from coverage before the divorce is finalized. | You have 31 days following your legal separation to remove your former spouse and stepchildren from coverage on hrsystems.azdoa.gov> YES portal> Life Events. In the Life Events Forms section, click "Legal Separation." See the Legal Separation Qualified Life Event User Guide for instructions. 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 to meet the 31-day deadline. After completing the SSA process, contact ADOA Benefits to have your name updated in YES. | Termination of coverage is effective at the end of the month following the date of the legal separation, after supporting documentation is received. Premiums are not refunded. If premiums change, new amounts will be billed beginning the first of the month following receipt of documentation. |
| Changes to Make Anytime | |||
| Activity | What You Can Do | How You Do It | When Coverage Begins |
| Beneficiary Changes | You may choose to change or update beneficiaries for your retirement plan, and deferred compensation program. | Retirement Plan: Login to the Arizona State Retirement System 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. | Changes are effective immediately following the submission of the applicable change of beneficiary forms. |
| Update Personal Information | You may need to change contact information for you, your former spouse, and your step-children. | To make changes to your contact information, visit hrsystems.azdoa.gov > YES portal> Bookmarks> Your Employee Services> Personal Information. To make changes to contact information for an ex-spouse or dependents, contact ADOA Benefits. | Changes are effective immediately. |
AGE 65 MEDICARE ELIGIBILITY
When you become eligible for Medicare at age 65 you will receive a notification as follows:
- Triple Choice Plan members - a letter from VibrantRx, the Medicare prescription drug plan, with information on how to enroll in the ADOA plan as a Medicare participant.
- HSA members - are not eligible for the HSA plan, you must enroll in the Triple Choice Plan.
You are also eligible to change coverage as shown in this chart. Read More
AGE 26 DEPENDENT TERMINATION PROCESS
Please refer to the Age 26 Dependent Termination Process document for full details.
Read More
TERMINATION OF EMPLOYER BENEFITS - OPTIONS TO CONTINUE COVERAGE
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
Read More
DEATH
Death of a spouse or dependent
Please submit the following forms to [email protected]
- Retiree Benefits Enrollment Form
- Death certificate
Read More
CHANGE IN PLACE OF RESIDENCE
If enrolled in DHMO dental plan, you may change to 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 - p. 9.
Please submit the following forms to [email protected]
LOSS OF ELIGIBILITY FOR MEDICAID OR CHIP COVERAGE
Changes must be made within 60 days. Coverage begins the first day of the next month following receipt of documentation. To see changes you can make, please refer to the QLE and Mid-Year Changes Chart - p. 11.
Please submit the following forms to [email protected]
CHANGE IN RETIREE, SPOUSE OR DEPENDENT EMPLOYMENT STATUS OR WORK HOURS
Changes affecting benefit eligibility for you, your spouse, and/or your dependents.
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]
ADDITIONAL LIFE EVENTS NOT LISTED
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].
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