The UNM-sponsored group health plans have a pre-tax status and are therefore governed by IRS regulations. Once you in enroll in coverage for medical, dental, vision, or a Flexible Spending Account (FSA), you cannot make changes to these plans outside of an Open Enrollment period, unless you experience a Qualifying Change in Status Event (Also known as a Qualifying Life Event).
Changes to your plan must be made within 60 calendar days of the Qualifying Change in Status Event.
Benefits election changes are effective the first day of the month after they have been received and approved by the Benefits Department. The only exception:
- In the event of birth, adoption, or placement for adoption of a child, medical coverage is effective retroactively to the date of birth, adoption, or placement for adoption.
If you are adding a dependent to your medical coverage as a result of a Qualifying Change in Status, you will also be required to submit dependent proof documents and dependent social security numbers to Aon Hewitt's Dependent Eligibility Verification Center.
If you are enrolling dependents for Dental and/or Vision coverage only, copies of dependent eligibility proof documents must be provided to the HR Service Center within 31 days of your enrollment. You may either drop the documents off at the HR Service Center (1700 Lomas Blvd NE, Suite 1400), or fax them to (505) 277-2278.
Examples of Required Dependent Proof Documents
Proof Documents Submission Requirements
How to Make Changes
- Medical, dental and vision coverage enrollment changes:
- Flexible Spending Account (FSA) changes:
- Life or Disability changes:
Qualifying events include:
- Birth/adoption/gain of legal guardianship
- Divorce, legal separation, or annulment
- Death of spouse or dependent
- The 26th birthday of your unmarried mentally or physically disabled child (an extension of coverage must be submitted)
- Employee or spouse employment change from part-time to full-time, or full-time to part-time, resulting in a change in eligibility
- Employee or spouse significant health coverage change attributable to spouse's employment
- Employment termination or commencement for the employee, a spouse, or a dependent
- Gain or Loss of other health coverage (including HealthCare Exchange coverage)
- Establishment/Dissolution of qualified domestic partnership
The requested change due to a Qualifying Change in Status Event must be consistent with the qualifying event (e.g., marriage and adding a spouse, birth and adding a newborn dependent, etc.)
Qualifying Change in Status Event: Required Support Documentation
Dis-Enrolling Dependents due to Loss of Dependent Eligibility
A dependent loses eligibility to participate in UNM sponsored plans if any of the following qualifying events occur:
- Dependent child turns 26 (coverage ends at the end of the month of your child's 26th birthday)
- Divorce of a spouse
- Dissolution of a domestic partnership
You must dis-enroll your dependents within 60 calendar days of any of the above qualifying events. Otherwise, you may be liable for any claims incurred by the ineligible dependent.
In most cases, a dependent may be eligible to continue insurance coverage through the provisions of COBRA. Please contact the HR Service Center at 505-277-MYHR (6947) for information about COBRA.
It is your responsibility to be sure that all of the dependents you enroll and continue to cover are eligible for benefits in accordance with the terms and conditions of the plan. If you enroll a dependent who does not meet eligibility requirements, or if you do not dis-enroll a dependent who no longer meets eligibility requirements, you may be responsible for any expenses incurred.
You MUST dis-enroll your ineligible dependent within 60 calendar days of any of the above qualifying events. To dis-enroll your dependent, you must submit election changes via the
Enrollment/Change Form and provide
Other plan changes
Plan changes that do not meet the criteria for qualifying events can only be made during UNM's annual Open
Enrollment - which traditionally occurs in late spring - for Medical, Dental, Vision, Life, Disability and
Accidental Death & Dismemberment plans. Changes made during Open Enrollment are effective the beginning of
the following Plan Year on July 1 (the Plan Year starts in the same calendar year that Open Enrollment is held).
Open Enrollment for Flexible Spending Accounts (FSA) occurs in late fall, and changes will take place on the
beginning of the following Plan Year, January 1 (of the following calendar year in which FSA Open Enrollment