Making a Change in Your Coverage Mid-Year/Life Event?
If you experience a qualified IRS life event/mid-year change, you may be permitted to make a change to your plan as permitted by the IRS, and your change has occurred within 31 days* of the event. If your change request is not completed within 31 days* of the event, you will not be able to change your elections until the following year’s annual benefits open enrollment period.
What is a IRS Qualifying Life Event/Mid-Year Change?
The following events may allow certain changes in benefits mid-year, if permitted by the Internal Revenue Service (IRS):
- Change in legal marital status (e.g., marriage, divorce/legal separation, dependent's death)
- Change in number or status of dependents (e.g., birth, adoption, dependent's death)
- Change in employee/spouse/dependent employment status, work schedule, residence that affects the eligibility for benefits
- Coverage of a child due to a Qualified Medical Child Support Order (QMCSO)
- Entitlement or loss of entitlement to Medicare or Medicaid
- Certain Changes in the cost of coverage, composition of coverage, or curtailment of coverage of the employee or spouse's plan.
- Changes consistent with special enrollment rights and FMLA leave
- If an employee is covered by a District-sponsored medical plan and the employee is eligible to enroll in Health Insurance Marketplace during its Open enrollment or Special enrollment period, the employee can request to be dropped from the medical plan to go enroll in the Health Insurance Marketplace.
You must notify the plan within 31 days* of a mid-year change-in-status event by making changes to your coverage and documentation supporting the change via the online enrollment system. The Plan will determine if your change request is permitted and if so, changes become effective prospectively, on the first day of the month following the approved change-in-status event (except for newborn and adopted children, who are covered back to the date of birth, adoption, or placement for adoption).
Please contact the Employee Benefits Department if you have questions.
* Note that the District will consider the date of the change in status as the first day for purposes of counting towards the 31-day deadline to make a mid-year change in your coverage.
Steps for Making a Mid-Year Change/Special Enrollment
Contact your Benefits Specialist to see if you have a qualifying event.
M. Michelle Bernal Karen Cardenas 480.472.0367 or firstname.lastname@example.org 480.472.0425 or email@example.com
Log on to the benefits online enrollment system MPS/BenefitFocus. Log in using your complete school email address and your active directory password.
Once you have logged in you will click on the "Edit/Enroll Now" button.
Once on the next page click on "Edit your benefits", the system will ask if you have recently experienced a life event? If you have or are experiencing a life event click on "New life event". From the drop down list find the reason for your life event. Then enter the date of the life event. If your life event is due to loss of other group health coverage please use the date other group coverage ends. Click next again. You should now be on the main page of benefits here you will edit each benefit you want to make a change to. As you go along making your changes please make sure to save changes as you go along. Once you have completed making your changes you will be asked to provide the required documentation for you change.
Special Enrollment Event & Required Documentation
- Marriage - a marriage license/certificate
- Birth - Hospital Proof of Birth or Birth Certificate
- Adoption -
- Loss of other group health coverage - Documentation must show the person(s) covered under other group health plan, type of coverage medical, dental, vision, etc. (you can only add to parts of the coverage that have been lost), and the effective date of loss of other group health coverage.
- Gained new group health coverage - Documentation must show the person(s) covered under new group health plan, type of coverage medical, dental, vision, etc. (you can only drop parts of the coverage that have been gained), and the effective date of other group health coverage.
- Medicaid/CHIP Event: You and your dependent may also enroll in this plan if you (or your dependents): - have coverage through Medicaid or State Children's Health Insurance Program (CHIP) and you (or your dependents) lose eligibility for that coverage. However, you must request enrollment within 60days after the Medicaid or CHIP coverage ends - become eligible for premium assistance program through Medicaid or CHIP. However, you must request enrollment within 60 days after you (or your dependents) are determined to be eligible for such assistance.
To request special enrollment or obtain more information, contact the Employee Benefits Department.
**Note that the District will consider the date of the special enrollment event as the first day for purposes of counting towards the 31-day special enrollment.