Qualifying Event Changes

"Qualifying Event Change" is the Internal Revenue Service rule that allows you to adjust your benefit selections when unforeseen circumstances occurred between open enrollments. Only specific events qualify as a change in family status.
 

Qualifying events include:

• Marriage or Divorce
• Death of spouse/child
• Birth, adoption or gain legal guardianship of a child
• Spouse changes employment resulting in the loss or gain of employer provided coverage
• You, your spouse or child involuntarily loses other health insurance coverage
• Eligible/ineligible for Medicare/Medicaid
• Change in eligibility status of a dependent
• Reduction in hours of employment – if the reduction did not allow enough pay to deduct the benefits currently enrolled
• Judgment/decree/order for coverage of children

If a qualifying event occurs, you must contact the benefits office within 30 days from the date the qualifying event date, and the family change must relate to the benefit change you are requesting. As an example, adding or dropping medical plan dependents is common in the case of birth, marriage, or divorce.

YES. Complete the Qualifying Event form. Include supporting documentation to support your request. For example:

1. Loss of Insurance Coverage - we will need a "Certificate of Creditable Coverage" from the previous health insurance carrier.
2. Spouse gains employment - we will need a written letter on company letterhead indicating the hire date and the effective date of your insurance. 
3. Divorce - we will need a copy of the divorce decree.
4. Marriage - we will need a copy of the marriage certificate.
5. Legal Adoption - we will need a copy of the court paperwork.

Your benefits are effective the 1st of the following month upon your qualifying event date. If you lost coverage in the middle of the month of January, your benefits with HEB ISD will start on February 1st. Unfortunately, we cannot skip a month.