What is a Qualifying Event?
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List of Qualifying Events:
- 1. Change in legal marital status, including marriage, death of a spouse, divorce, legal separation and annulment.
- 2. A change in the number of dependents, including birth, death, adoption, and placement for adoption.
- 3. A change in employment status of the employee, or the employee's or retiree's spouse or dependent, including termination or commencement of employment, a strike or lockout, a commencement of or return from an unpaid leave of absence, a change in worksite, and a change change in working conditions (including changing between part-time and full-time or hourly and salary) of the employee, the employee's or retiree's spouse or dependent which results in a change in benefits they receive under a cafeteria plan or health or dental plan.*
- 4. A dependent ceasing to satisfy eligibility requirements for coverage due to attainment of age, student status marital status, or of similar circumstances. *
- 5. A change in place of residence of the employee, retiree or their spouse or dependent and the current carrier is not available.
- 6. Significant cost or coverage changes (including coverage curtailment and the addition of a benefit package).
- 7. Family Medical Leave Act (FMLA) leave.
- 8. Judgments, decrees, or orders.
- 9. A change in coverage of a spouse or dependent under another employer's plan.
- 10. Open enrollment under the plan of another employer.
- 11. Health Insurance Portability and Accountability Act (HIPPA) special enrollment rights for ne dependents and in the case of loss of other insurance coverage.
- 12. A COBRA-qualifying event.
- 13. Loss of coverage under the group health plan of a governmental or educational institution (a state's children's health insurance program, medical care program of an Indian tribal government, state health benefits risk pool, or foreign government group health plan).
- 14. Entitlement to Medicare or Medicaid.
- 15. Any other situations in which the group health or dental plan is required by the applicable federal or state law to allow a change in coverage.