About Qualifying Change in Status Events
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, you cannot make changes* to these plans outside of the annual Open Enrollment period, unless you experience a Qualifying Change in Status Event (also knowns as a Qualifying Life Event).
Changes to your coverage must be made within 60 calendar days of the Qualifying Change in Status Event by submitting your Enrollment Change Form(s) to the Benefits Department, located at the HR Service Center, 1700 Lomas Blvd NE, Suite 1400. See “Important Note” below.
Qualifying Change in Status Events include but are not limited to the following. Keep in mind that the change in benefits you are seeking must match the event that occurred. A change in one type of event may not allow for a change in other benefit elections. For example, if you have a child, you may not use that event to also discontinue dental coverage for a spouse.
- Birth, adoption, or gain of legal guardianship
- Divorce, legal separation, or annulment of marriage
- Death of employee, or 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 or dissolution of qualified domestic partnership
Use the Qualifying Change In Status Event: Required Support Documentation guide to help identify documents you may have that demonstrate the event you have experienced from the list above.
It is critical that you submit your Enrollment Form within 60-calendar days of your Qualifying Change in Status Event, even if you are still waiting for your supporting documentation of the event (i.e. birth certificate/proof of birth, proof of loss/gain of other coverage from the other insurance entity, marriage certificate etc.).
Do not wait for your documentation or you risk missing your 60-calendar day deadline.
*IRS Guidance Provides Temporary Flexibility for 2020 Mid-Year Changes in Response to the COVID-19 Pandemic.
The Internal Revenue Service (IRS) released new guidelines on May 12, 2020 to allow temporary flexibility with regard to health (medical/dental and/or vision) plan changes and Flexible Spending Accounts (FSA) during the COVID-19 pandemic, through December 31, 2020. The temporary IRS guidelines permit certain prospective mid-year changes directly related to COVID-19 limitations and restrictions.
Contact Benefits & Employee Wellness at email@example.com for further information about making any benefits changes under the following categories:
Health Plans (Medical, Dental, Vision)
- Enroll in coverage
- Cancel existing coverage**
- Make a tier change to elections (example: Change from single to family coverage)
All changes are effective the first of the next month after your Medical/Dental/Vision Change Form has been received and approved by Benefits & Employee Wellness.
Flexible Spending Accounts (FSA)
- Enroll in an FSA
- Cancel existing FSA election
- Increase annual FSA election
- Decrease annual FSA election
All changes are effective the first of the next month after your FSA Enrollment/Change Form has been received and approved by Benefits & Employee Wellness.
Additional temporary IRS COVID-19 Relief changes for FSA in 2020
**If you are cancelling your UNM Medical, Dental, and/or Vision Coverage, you are required to complete an Attestation Form of your enrollment in other coverage. Cancellation of Medical, Dental, and/or Vision coverage will not be accepted unless accompanied by the Attestation Form. Contact Benefits & Employee Wellness at firstname.lastname@example.org for more information.
How to Make Benefits Changes***
- Complete the form required for the benefit you are updating:
- Medical/Dental/Vision Enrollment/Change Form
- Flexible Spending Account (FSA) Enrollment/Change Form
- Life, Accidental Death & Dismemberment, and Disability Benefits Enrollment
- Submit the form to Benefits & Employee Wellness within the required 60 calendar days of the qualifying event occurring. (See “Important Note” above)
- Once your request has been received and approved by Benefits & Employee Wellness, your benefits election changes are effective the first day of the following month.
The only exception of election changes is in the event of a birth, adoption, or placement for adoption of a child. If this occurs, the medical coverage is effective retroactively to the date of birth, adoption, or placement for adoption.
***If your benefits changes are COVID-19 related, refer to the temporary 2020 IRS guidance above.
Adding a Dependent
If you are adding a dependent you will be required to provide proof documents within 31 days of your enrollment request (reference “Important Note” above). Please note that it is your responsibility to be sure that all the dependents you enroll and continue to cover are eligible for benefits in accordance with the terms and conditions of the plan.
For medical coverage, upon receipt of your enrollment form, Benefits & Employee Wellness will notify its third-party dependent verification company, Alight Solutions. Alight Solutions will mail you instructions to your address on file and a deadline date to provide proof documents via fax or upload to their online portal.
If you are electing dental and/or vision only, provide copies of proof documents to the HR Service Center at the John and June Perovich Business Center, located at 1700 Lomas Blvd. NE, Suite 1400, or fax them to 505.277.2278.
See the Proof Documents Submission Requirements info sheet for a summary of what is required for those that are newly benefits eligible versus those who qualify for a change in status.
Removing a Dependent
It is your responsibility to dis-enroll your dependent within 60 calendar days of a qualifying event (see “Important Note” above). 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 .Keep in mind that 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 from a spouse
- Dissolution of a domestic partnership
To dis-enroll your dependent, you must submit election changes via the Enrollment/Change Form and provide supporting documentation.