Changes in Family Status
Under the Pace University group health plans and Flexible Spending Accounts, employees and their eligible dependents may enroll when they first become eligible for coverage and annually during the Open Enrollment period. When you enroll in benefits, your elections remain in effect to the end of the calendar year (December 31st) and changes to your election are not permitted until the next Open Enrollment period. Open Enrollment is typically conducted in late October or early November for an effective date of January 1st. However, if you experience a qualifying change in family status during the plan year, you may be eligible to make a mid-year change to your benefits that corresponds with the life-changing event. See the Family Status Changes Chart below for a list of qualifying events.
Enrollment and Effective Dates
To change your coverage when a qualifying life event occurs, you must notify the University Benefits office within 31 days of the date of the qualifying event for the anticipated change to be considered. Once the 31 day-timeframe expires, you are only able to make a change during the next annual Open Enrollment period. Changes made during Open Enrollment are effective as of January 1st.
In most cases, the effective date of the enrollment/termination is the 1st of the month following the date of the qualifying event. However, in some situations (birth of a child), the effective date is the same date the actual life event occurred.
In addition to the completion/submission of certain benefits forms, you must provide documentation to support the type of qualifying change as well as the effective date. You must also provide a marriage certificate to add your spouse to the health plans and birth certificates to add your dependent children. Copies of Social Security cards are required for all dependents.
Family Status Changes
Change in Employee's Marital Status
Marriage/Domestic Partnership
Healthcare Plan Coverage Options:
- Can enroll spouse/domestic partner (and any eligible affected children) in the plan
- Can drop coverage and join your spouse's employer health plan
Plan Changes Options:
- May change medical/dental plan
Required Documentation:
Marriage:
- Benefits Enrollment Form
- Marriage License
Domestic Partner:
- Notarized Statement of Domestic Partnership (PDF)
- Supporting Documentation (utility bills,lease, etc - other proof of financial interdependence)
- Benefits Enrollment Form
Divorce, Legal Separation, Annulment, Termination Domestic Partnership
Healthcare Plan Coverage Options:
- Add coverage, including children (if lost coverage under spouse's/domestic partner's plan).
- Eliminate coverage for spouse/domestic partner
Plan Changes Options:
- May change medical/dental plan
Required Documentation:
- Letter of Proof Coverage Terminated (Copy of Legal Documentation) Notarized statement from employee stating that domestic partnership has ended.
- Benefits Enrollment Form
Death of Spouse
Healthcare Plan Coverage Options:
- Add coverage, including children (if lost under spouse's plan).
- Eliminate coverage for spouse
Plan Changes Options:
- TBD
Required Documentation:
- Certified Death Certificate
- Benefits Enrollment Form
Increase in Number of Dependents
Birth, Adoption or Placement for Adoption
Healthcare Plan Coverage Options:
- Add new child only.
- Add spouse (if applicable).
Plan Changes Options:
- May change medical/dental plan
Required Documentation:
- Birth Certificate - as soon as available
- Copy of Social Security Card - as soon as available
- Adoption/Placement - Copy of guardianship letter from attorney/adoption agency
- Marriage License (if adding spouse)
- Benefits Enrollment Form
Decrease in Number of Dependents
Reaching Limiting Age
Healthcare Plan Coverage Options:
- Eliminate child's coverage
Plan Changes Options:
- TBD
Required Documentation:
Healthcare Plan Coverage Options:
- Eliminate child's coverage
Plan Changes Options:
- TBD
Required Documentation:
- Benefits Enrollment Form
- Death Certificate
Change in Employment (Spouse or Dependent)
Commence New Job - Gain Medical Plan Coverage Eligibility with Spouse's/Domestic Partner's new employer
Healthcare Plan Coverage Options:
- Drop coverage for self and family to enroll in new employer's plan
Plan Changes Options:
- TBD
Required Documentation:
- Benefits Enrollment Form
- Proof of Coverage through New Employer
Spouse/Domestic Partner Terminates Employment - Loss of Medical Plan Coverage with Spouse's Former Employer
Healthcare Plan Coverage Options:
- Elect coverage
- Add dependents to plan
Plan Changes Options:
- Select medical/dental plan
Required Documentation:
Retire - May be eligible for coverage under "Rule of 75" ~ contact University Benefits office for review of your eligibility Ext. 22828.
Healthcare Plan Coverage Options:
- Drop or add spousal coverage based on eligibility
Plan Changes Options:
- Select medical plan
Required Documentation:
- Per instructions from Benefits Office
Other Plan Annual Enrollment (Spouse or Dependent)
Annual Open Enrollment - Eligible for Other Coverage through Spouse/Domestic Partner on Different Plan Year
Healthcare Plan Coverage Options:
- Drop coverage for self and family members thereby enrolling in dependent's coverage.
- Elect coverage/add dependents to employee's plan who were previously covered under another plan
Plan Changes Options:
- Select medical plan
Required Documentation:
- Benefits Enrollment Form
- Proof of Coverage Letter from spouse/domestic partner's employer
Legal Proceedings
Court Order, Judgment or Decree
Healthcare Plan Coverage Options:
- Adhere to Court Order
Plan Changes Options:
- Based on Court Order
Required Documentation:
- Letter of Proof Coverage Terminated (Copy of Legal Documentation)
- Benefits Enrollment Form