Qualified Life Events | Retirees

Since you are now enrolling as a retiree, you will need to supply supporting documentation, such as marriage licenses and birth certificates for your covered dependents.

• Supporting Documentation List

Here is the full chart of all possible QLE changes. 

• QLE and Mid-Year Changes Chart

• Premiums
  • If your premiums change as a result of a QLE, new amounts will be deducted beginning the pay period following the effective date of your coverage.
  • No premium refunds for retroactive termination will be provided if notification of QLE is received beyond 31 days of the event.
  • To see the new premiums, review the Active Enrollment Guide.

• 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 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).

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.
• To make changes to contact information for an ex-spouse or dependents, contact ADOA Benefits.  

Beneficiary Changes

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

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

• 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 

Educational Savings Plans - AZ529

• Visit the AZ529.gov website for more information about participating in a 529 college savings plan. 

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 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.
• Please note that newborn children are covered under their mother’s insurance only for the first 31 days of their life. This time includes several doctor's appointments, so it seems that the infant is "automatically" covered. They are not. After 31 days, they must be enrolled under their own name, or they will not be covered.
• Supporting Documentation: Birth 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 birth after all supporting documents are received.

Additional Changes

• To update your personal information, make beneficiary changes, and enroll in a college savings plan from AZ529, see "Anytime Changes" above.

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 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.
• Coverage begins on the date of birth, after all supporting documents are received.
• Supporting Documentation: Birth 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. 

Additional Changes

• To update your personal information, make beneficiary changes, and enroll in a college savings plan from AZ529, see "Anytime Changes" above.

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 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 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.
• Electing coverage: Coverage begins the first day of the next month following receipt of required documentation.
• Removing coverage: Termination of coverage is effective the last day of the pay period in which the Member makes a last contribution.

Additional Changes

• To update your personal information and make beneficiary changes, see "Anytime Changes" above.

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." See the Divorce Qualified Life Event User Guide for instructions. 
• 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 ADOA Benefits at [email protected] to have your name updated in YES. Your status and personal contact info are updated immediately in YES when you make the change. 
• Termination of coverage is effective on the date of the divorce decree 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 update your personal information and make beneficiary changes, see "Anytime Changes" above.

Changes During 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 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. 
• 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." See the Legal Separation Qualified Life Event User Guide for instructions. 
• 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 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.

Additional Changes

• To update your personal information and make beneficiary changes, see "Anytime Changes" above.

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 on page 11 of the QLE Changes Chart.

Please see the Age 26 Dependent Termination Process document for 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

Please submit the following forms to [email protected]

• Retiree Benefits Enrollment Form
• Death certificate

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, page 9. 

Please submit the following forms to [email protected]

• Retiree Benefits Enrollment Form
• Required supporting documentation

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]

• Retiree Benefits Enrollment Form
• Required supporting documentation

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]

• Retiree Benefits Enrollment Form
• 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].