What Is A Qualified Life Event?

You should always elect benefits during open enrollment to ensure you get the coverage you need; however, once enrolled in health coverage like a cafeteria or Section 125 plan, you are unable to change your elections until the plan year ends. But sometimes qualified life events occur, allowing you to change elections outside the standard enrollment period.

How Do I Qualify?

Qualified events can be specific to individual plan offerings, but some common examples can be found below:

  • Change in status (legal name, marital status, number of dependents and others)
  • Significant plan cost changes
  • Significant curtailment of coverage
  • Change in coverage under other employer’s plan
  • Addition or significant improvement of benefits package options
  • FMLA leaves of absence
  • Loss 0f group health coverage sponsored by a governmental or educational institution
  • COBRA qualifying events
  • HIPAA special enrollment events
  • Medicare or Medicaid entitlement

How Can I Change My Elections Midyear?

  • You must experience a midyear election change event recognized by the IRS.
  • The cafeteria plan must permit midyear election changes for that event.
  • Your requested change must be consistent with the midyear election change event.

Please note that certain qualified events can complicate health plan enrollment.

Sometimes qualified life events occur, allowing you to change elections outside the standard enrollment period

Do you have questions regarding qualified life events?

Touch base with our Employee Benefits team.

Request an appointment today

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