If you have a life change, such as getting married or having a baby, you should make sure your benefit coverage continues to match your needs. In most cases, you cannot change your benefit elections until the next annual Open Enrollment period. If the event occurs during the year, special rules apply to changing coverage.
Qualified Event/Family Status Changes
You can change your benefit elections outside of Open Enrollment only if you have a Qualified Event or Family Status Change, which include:
- Have a baby/adopt a child
- Change in marital status
- Gain/loss of other group coverage, including Medicare/Medicaid
- One of your dependents gains/loses other group coverage, including Medicare/Medicaid
- Employment change that affects your benefits
- You become disabled or die
If you have a Qualified Event or Family Status Change and want to make benefit changes during the year:
- You must make any benefit changes within 30 days of the qualified event.
- Changes must be consistent with the Family Status Change. For example, if you have employee only medical coverage and get married, you may waive coverage or change your medical coverage category to employee + spouse. You may also add your spouse to other coverages. Coverage for a new spouse begins the first of the month following the marriage date. Coverage for a newborn begins on date of birth. You must already be enrolled at the time of the qualifying event in order to add your spouse or newborn child to your coverage. Otherwise, you must wait until the next Open Enrollment period.
- You must provide necessary verification documentation for your dependents (proof of loss or gain of other coverage) within 30 days of the qualified event. You may fax the documentation to 949-328-2763 or email it to firstname.lastname@example.org. Be sure to include a cover sheet with the documentation that includes your name, and employee ID number. Email is preferred over faxing. If you fax your documentation, make sure no pages stick together as you feed the pages into your fax machine to ensure all pages are successfully transmitted. Coverage changes go into effect the first of the month after the qualifying event. For example, if coveraged ends on August 31, you coverage with Ensign begins on September 1.
- If you are adding new dependents to your coverage based on a qualifying life event, you must provide necessary documentation to confirm eligibility (such as a marriage or birth certificate) at the time of enrollment. Your elections will not be approved until the necessary documentation is received. You can submit your documentation on the last Workday enrollment screen by uploading them before you submit your enrollment elections in Workday. You can also email your documentation to email@example.com.Be sure to include your name and employee ID number with your submitted documentation.