Mid-Year Family or Life Status Changes

The elections you make during Annual Enrollment will remain in effect for the plan year until the next Annual Enrollment period,  January 1 through December 31 each year. If your life or family status changes during that time, however, you may be permitted to change your benefits coverage to accommodate your new situation. If you've enrolled in a plan, you cannot change your election but may modify the level of your coverage. Generally, you may change your elections if:

  • You get married or divorced; enter into or terminate a domestic partnership.
  • You gain or lose a dependent (such as through birth, death or adoption).
  • Your spouse/domestic partner takes or loses a job that provides benefits.

If any such event occurs, within 31 days of the event, you need to complete an Enrollment/Change Form. You may be required to provide documentation verifying the change. The chart below shows some examples of enrollment changes permitted by a change in your life or family status.

 
Medical
Life Ins.
Dependent Care
Assistance
Account
Marriage/Domestic Partnership

Affidavit of Domestic Partnership Form		 Employee may enroll newly eligible spouse/domestic partner and dependent children May enroll spouse/domestic partner subject to evidence of insurability and/or dependent children without evidence of insurability. May enroll or increase to accommodate newly acquired dependents, decrease or cease spouse/domestic partner coverage if they are not employed. 
Divorce or Death 
of Spouse/Domestic Partner, Legal Separation or Annulment		 May revoke election only for spouse/ domestic partner where applicable.  Employee may elect coverage for self or  dependents who lose eligibility under spouse/domestic partner's plan if such individual loses eligibility as a result of the divorce, legal separation, annulment or death. Employee may increase optional subject to evidence of insurability. May drop spouse/domestic partner or increase dependents subject to evidence of insurability.  May enroll, or increase to accommodate newly eligible dependents( e.g., due to divorce from non-working spouse) or decrease or cease coverage if eligibility is lost due to an event (e.g., dependent now resides with ex-spouse).
Death of Dependent or Spouse/Domestic Partner  Employee may drop coverage only for the dependent or spouse/domestic partner who becomes deceased. May drop coverage of dependent or spouse/domestic partner. May decrease or stop election for a dependent who becomes deceased.
Birth/Adoption
(Adoption certificate 
required)		 Employee may elect or increase coverage for newly acquired dependent and any other dependents who were not previously covered. May add coverage without evidence of insurability. May enroll or increase to accommodate newly eligible dependent(s).
Spouse, Domestic
Partner Begins
Employment or Other Employment Event (e.g., going from part-time to full time with benefits)  		Employee may revoke election for employee, spouse/domestic partner, or dependent coverage if employee, spouse/domestic partner, or dependent is added to spouse/domestic partner's coverage. Changes can only be made subject to evidence of insurability. Employee may make or increase election to reflect new eligibility (if spouse/domestic partner previously did not work or if their work has changed such as part-time to full-time).
Spouse, Domestic
Partners Termination or Other Change in Employment
Such as Unpaid Leave, Full-time to Part-time, Strike Resulting in Lost Eligibility.		 Spouse/domestic partner and or dependents may be added to employee's plan.  Changes can only be made subject to evidence of insurability. May enroll or decrease the election.


Please Note: The children of a domestic partnership must meet eligibility requirements(i.e. be a tax dependent of the employee).