Life is a continuing process of change —sometimes planned and sometimes unexpected. These major changes are called qualified life events (QLE) and are governed by the IRS regulations of Section 125 Cafeteria Plans and HIPAA Special Enrollment Rights. 

When one of these changes occurs, you may need to make changes to your benefits. Please be aware changes can only be made within 45 days from the date of the QLE.

Qualifying Life Events include, but are not necessarily limited to:

  • Marriage

  • Divorce

  • Having or adopting a baby/child

  • Death

  • Turning 26 or becoming eligible for Medicare

  • Change in employment status for you or your spouse

  • Gain/loss of coverage

Special Instructions

  • Employees may enroll, terminate, or change benefits outside of Open Enrollment if a QLE occurs.

  • Employees with a QLE must make any necessary changes/additions to benefits within 45 days from the date of the event.

  • If required paperwork is received outside of 45 days from date of life event, the employee will not be able to make any changes until the next annual Open Enrollment with an effective date of Jan. 1 of the following year.

  • The coverage begin date of a QLE for the birth of child or divorce must start on date of the event. All other types of events may start at the beginning of the next payroll cycle following the date of the event.

  • Incapacitated adult dependents may be eligible for certain benefit coverages after turning 26. Please email benefit@auburn.edu for more information.

  • For more information or to request benefit forms for QLE changes please contact benefit@auburn.edu.

Premiums

  • Any back premiums owed to Auburn University will be taken from the employee’s check on the following payroll date after approval.

  • Auburn University does not prorate premiums. If an employee waits until the payroll date has passed for the QLE date, no premiums will be reimbursed.

Required Documentation

HIPAA Special Enrollment

This applies to eligible employees who declined healthcare benefits at initial enrollment or Open Enrollment but lost other coverage or acquired a new spouse/dependent.

The life and disability programs are not subject to HIPAA Special Enrollment requirements. In a HIPAA Special Enrollment situation, eligible employees may elect new coverage for their eligible family members. 

Medical, Dental, and Vision

  • Elect coverage.

  • Add spouse and/or dependents who lost coverage.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

Evidence of loss of previous coverage.

Coverage Change Effective Date

Coverage begins the first day of the next pay cycle following the date of the event.

Medical, Dental, and Vision

  • Elect coverage.

  • Add spouse and/or dependents who lost coverage.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

Notice of eligibility for premium assistance, or evidence of loss of previous CHIP/Medicaid coverage

Coverage Change Effective Date

Coverage begins the first day of the next pay cycle following the date of the event.

Medical, Dental, and Vision

  • Elect coverage for newly acquired spouse and/or dependent child(ren).

  • Decline - coverage provided by spouse’s coverage.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility. 

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Legal marriage certificate.

  • Stepchild(ren) require both birth and legal marriage certificates.

Coverage Change Effective Date

  • Electing coverage: Coverage begins on the date of the marriage or the first day of the next payroll cycle following the date of the event.

  • Removing coverage: Termination of coverage is effective the last day of the pay cycle following the date of event.

IMPORTANT: Newborns are not automatically added to the policy. Required documentation must be submitted in order to effectively add coverage.

Medical, Dental, and Vision

  • Elect coverage for newly acquired spouse and/or dependent child(ren).

  • Decline - coverage provided by spouse’s coverage.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Stepchild(ren) require both birth and legal marriage certificates.

  • Birth certificate (A hospital verification letter is accepted for enrollment until a birth certificate is issued.)

  • Legal adoption, guardianship or court order paperwork.

Coverage Change Effective Date

  • Electing coverage: Coverage begins on the date of the event for birth, adoption, and placement for adoption.

  • Removing coverage: Termination of coverage is effective the last day of the pay period which the member makes a last contribution.

Other Qualified Life Events

These are events that may allow for certain benefits to be changed mid-year.

Change in Family Status

IMPORTANT: The spouse must be removed from the plan regardless of a court order to continue their coverage. COBRA benefits are an available option for spouses dropped from coverage. If you declined benefits and your divorce results in you losing coverage under your spouse’s health insurance, see Loss of Other Coverage under HIPAA Special Enrollment.

Medical, Dental, and Vision

  • Remove the spouse from all current coverage (mandatory).

  • Remove stepchild(ren) from all current coverage unless there is evidence of adoption by the employee.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage

  • Elect child life insurance up to the maximum or reduce/cancel coverage

  • Remove the spouse from coverage.

  • Remove stepchild(ren) from all current coverage unless there is evidence of adoption by the employee.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Divorce decree

  • Notice of legal separation

  • Notice of legal annulment

  • Evidence of previous coverage under spouse

  • Legal adoption papers

  • Legal guardianship papers

  • Death certificate

Coverage Change Effective Date

For removing/reducing coverage:

  • Termination of coverage is effective the date of the event.

  • Premiums are not refunded.

  • If there is a change in premiums, new amounts will be deducted beginning with the pay period following the date of event.

IMPORTANT: Coverage cannot be declined for a qualified medical child support order (QMCSO) unless it is court ordered.

Medical, Dental, and Vision

  • Add/remove coverage for the eligible dependent child(ren).

  • For a QMCSO, elect mandated court-ordered coverages.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Legal adoption papers

  • Legal guardianship papers

  • Stepchild(ren) require both birth and legal marriage certificates.

  • Legal court orders

  • Qualified Medical Child Support Order (QMCSO)

Coverage Change Effective Date

Coverage begins the day of the event.

Medical, Dental, and Vision

  • Remove the dependent from all coverage.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Remove/cancel dependent life insurance.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Death certificate

  • Legal court orders

Coverage Change Effective Date

Removing/reducing coverage:

  • Termination of coverage is effective the date of the event.

  • Premiums are not refunded.

  • If there is a change in premiums, new amounts will be deducted beginning with the pay period following the change.

CHANGE IN EMPLOYEE'S, SPOUSE'S, OR DEPENDENT'S EMPLOYMENT STATUS

Medical, Dental, and Vision

  • Decline any/all coverages now provided to the member by the spouse's coverage.

  • Remove the spouse or dependent from any/all coverage now provided through their employment.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Evidence of new coverage under spouse.

  • Spouse’s evidence of new coverage.

Coverage Change Effective Date

Termination of coverage is effective the last day of the pay period in which the member makes a last contribution.

See loss of coverage under HIPAA special enrollment.

Medical, Dental, and Vision

  • Elect any/all coverages previously provided to the member and/or eligible dependents by the spouse's coverage.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Evidence of previous coverage under spouse (i.e. letter from employer or letter of creditable coverage).

Coverage Change Effective Date

Coverage begins the first day of the next pay cycle following the date of the event.

Note: This includes military leave. 

Medical, Dental, and Vision

  • Decline or reduce coverage tier of current medical, dental and/or vision.

Life and Disability

  • Cancel supplemental life insurance.

  • Cancel dependent life insurance.

  • Cancel the voluntary long-term disability buy-up.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

IMPORTANT: If healthcare FSA contributions are reduced, expenses incurred during unpaid leave will not be reimbursed.

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Verification of approved leave or change in work hours.

Coverage Change Effective Date

Termination of coverage is effective the last day of the pay period in which the member makes a last contribution.

Note: This includes military leave. 

Medical, Dental, and Vision

  • Re-elect the previous level of medical, dental and/or vision coverage.

Life and Disability

  • Re-elect the previous level of supplemental life if previously declined.

  • Re-elect the previous level of dependent life if previously declined.

  • Re-elect the voluntary long-term disability buy-up.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Verification of declination of previous coverage.

  • Verification of current payments.

Coverage Change Effective Date

Coverage begins the first day of the next pay cycle following the date of the event.

IMPORTANT: Premiums must be current in order to re-elect coverage. If premiums are not current, changes will need to be made during the next open enrollment period.

Change in Dependent Eligibility Under Plan Terms

Medical, Dental, and Vision

  • Remove the dependent who is no longer eligible (mandatory).

Life and Disability

  • Remove the dependent who is no longer eligible.

  • Cancel dependent life if there are no remaining eligible dependents.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • No documentation is required.

Coverage Change Effective Date

  • Termination of coverage is effective the last day of the dependent child’s birth month at age 26 for medical, age 24 for dental and vision; the birthdate for all voluntary products.

ENTITLEMENT AND/OR CANCELLATION OF MEDICARE OR MEDICAID COVERAGE

See HIPAA Special Enrollment.

Medical, Dental, and Vision

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Life and Disability

  • Remove the dependent who is no longer eligible.

  • Cancel dependent life if there are no remaining eligible dependents.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Evidence of previous Medicare or Medicaid coverage.

Coverage Change Effective Date

  • Coverage begins the first day of the next pay cycle following the date of the event.

Medical, Dental, and Vision

  • Decline coverage or remove the dependent now covered by Medicare or Medicaid.

Life and Disability

  • Elect supplemental life insurance up to the maximum or reduce/cancel coverage.

  • Elect dependent life insurance up to the maximum or reduce/cancel coverage.

  • Elect the voluntary long-term disability buy-up or cancel coverage.

  • Update beneficiary information. (This can be done at any time.)

IMPORTANT: Declining supplemental life and/or dependent life will void the waiver of premium eligibility.

Flexible Spending Accounts

  • Elect, increase, or decrease the healthcare FSA*

  • Elect, increase, or decrease the dependent care FSA*

* Special provisions apply to FSAs during QLEs and require communications with Benefits Staff. 

Which Supporting Documentation is Needed? (Copies are sufficient)

  • Evidence of Medicare or Medicaid enrollment.

Coverage Change Effective Date

  • Termination of coverage is effective the last day of the month prior to the month of entitltment.

Last updated: 09/30/2024