ListofQualifyingEvents
1. Changeinlegalmaritalstatus,includingmarriage,deathofaspouse,divorce,legalseparationandannulment.
2. Achangeinthenumberofdependents,includingbirth,death,adoption,andplacementforadoption.
3. Achangeinemploymentstatusoftheemployee,ortheemployee’sorretiree’sspouseordependent,including
terminationorcommencementofemployment,astrikeorlockout,acommencementoforreturnfroman
unpaidleaveofabsence,achangeinworksite,andachangeinworkingconditions(includingchangingbetween
partͲtimeandfullͲtimeorhourlyandsalary)oftheemployee,theemployee’sorretiree’sspouseordependent
whichresultsinachangeinbenefitstheyreceiveunderacafeteriaplanorhealthordentalplan.*
4. Adependentceasingtosatisfyeligibilityrequirementsforcoverageduetoattainmentofage,studentstatus,
maritalstatus,orothersimilarcircumstances.*
5. Achangeinplaceofresidenceoftheemployee,retireeortheirspouseordependentandthecurrentcarrieris
notavailable.
6. Significantcostorcoveragechanges(includingcoveragecurtailmentandtheadditionofabenefitpackage).
7. FamilyMedicalLeaveAct(FMLA)leave.
8. Judgments,decreesororders.
9. Achangeincoverageofaspouseordependentunderanotheremployer’splan.
10. Openenrollmentundertheplanofanotheremployer.
11. HealthInsurancePortabilityandAccountabilityAct(HIPPA)specialenrollmentrightsfornewdependentsand
inthecaseoflossofotherinsurancecoverage.
12. ACOBRAͲqualifyingevent.
13. Lossofcoverageunderthegrouphealthplanofagovernmentaloreducationalinstitution(astate’schildren’s
healthinsuranceprogram,medicalcareprogramofanIndiantribalgovernment,statehealthbenefitsriskpool,
orforeigngovernmentgrouphealthplan).
14. EntitlementtoMedicareorMedicaid.
15. Anyothersituationsinwhichthegrouphealthordentalplanisrequiredbytheapplicablefederalorstatelaw
toallowachangeincoverage.