Qualifying Life Events and Open Enrollment
Qualifying Life Events
Qualifying Life Event are specific life or employment eligibility changes that may effect your health insurance needs. When such an event occurs, an employee may permitted to add, change or drop their current health plan to reflect the life event. Qualifying event changes must be made within 31 days of the event with required documentation.
Elections for pre-tax group health insurance are generally irrevocable for the plan year under Section 125 of the Internal Revenue Code. However, the Internal Revenue Service (IRS) provides specific instances and timing of when an employee can make midyear election changes. As we offer these plans pre-tax we must abide by IRS rules for making changes, which is only during the annual open enrollment period or with qualifying events within the 31-day window and required documentation, exceptions are prohibited.
Select a Qualifying Event below for details and the specific documentation required for each event.
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Marriage is a qualifying event to enroll yourself, spouse or child dependent in a plan or to waive your coverage.
You must submit your Change Benefits request and upload required documentation on Workday within 31 days of the event date. Effective date is the date of marriage. Changes are retroactive to the effective date. Request cannot be approved without documentation.
Marriage documentation includes the following information:
- Marriage certificate (preferred)
- Top half of most recent tax return which list spouse and/or dependent(s) (alternate)
Also needed:
- Social Security Number
- Birth Certificate (if adding children)
Please note: if your new spouse is currently listed as a life insurance beneficiary or emergency contact with a relationship status of friend, partner or fiance, you will need to update their relationship status to spouse before you can add them to your plan. Workday will think you are trying to add a new person with the same information and you will get duplicate entries or an error message.
To change the relationship status:
Workday Home, in upper left corner Menu, Benefits, Change: Beneficiary, choose Edit next to their name, update relationship status.
Workday Home, Menu, Benefits Change:Benefits, Reason: Marriage
See Workday Job Aid Updating Benefits-Qualifying Events to guide you through the process.
A new child is a qualifying event to enroll yourself, spouse or child dependent in a plan or to waive your coverage.
After your baby arrives you must submit your Change Benefit request and upload required documentation on Workday with 31 days of the event. The effective date is the date of the baby’s birth, adoption date or placement date. Changes are retroactive to the effective date. Requests may not be approved without documentation.
Documentation includes the following information:
- Birth Certificate or;
- Birth Record from the hospital,
- Adoption or adoption placement paperwork with date medical care must commence.
If adding a spouse or other children include:
- Marriage Certificate
- Birth Certificate for children
- Social Security Number
Workday Home, Menu, Benefits Change:Benefits, Reason: Birth
See Workday Job Aid
Updating Benefits-Qualifying Events to guide you through the process.
A change in job status for you, your spouse or eligible dependent is a qualifying event if it changes benefits eligibility or changes the cost of benefits.
Loss of coverage
Loss of coverage due to job loss, reduction of hours, or open enrollment is a qualifying event to enroll yourself, spouse or child dependent to a plan.
You must submit your Change Benefit request and upload required documentation on Workday within 31 days of the event. Coverage is retroactive to the first day without coverage (e.g. old coverage ends 5/31, new Brandeis coverage effective date is 6/1). Request cannot be approved without documentation.
Loss of coverage documentation from the employer/insurer includes the following information:
- Loss of coverage reason
- End of coverage date
- Plan types ending (medical, dental, vision)
- Persons covered (includes you and/or spouse/children)
If adding spouse or children include:
- Marriage
- Birth Certificates -children
- Social Security Numbers
Gaining other coverage:
If you or your dependents gain other coverage due to a qualifying event (such as new hire, newly benefit eligible or open enrollment) you may remove dependents or waive coverage for yourself and any covered dependents.
You must submit your Change Benefit request and upload required documentation on Workday within 31 days of the event. The Brandeis coverage end date is the effective first day of new coverage. Request cannot be approved without documentation.
New coverage documentation from the employer/insurer includes the following information:
- Qualifying event reason
- Coverage begin date
- Plan types enrolled
- Persons covered
Please Note: Your health care ID card is not sufficient documentation. It does not have the required information.
Workday Home, Menu, Benefits Change:Benefits, Reason: loss of coverage
See Workday Job Aid Updating Benefits-Qualifying Events to guide you through the process.
Reaching age 26 and aging off a plan is a qualifying event.
Dependent Enrolled on a Brandeis Plan
If enrolled in the Brandeis University Group Health, Dental, or Supplemental Vision plans the coverage will continue through the last day of the month in which your dependent turns 26.
Workday will automatically process this event you do not need to do anything.
COBRA Continuation CoverageIn accordance with the federal law known as COBRA, dependent children may be eligible to continue group membership in health, dental and/or supplemental vision insurance plans for up to 36 months, in most cases.
Our COBRA administrator, Health Equity/WageWorks, will automatically mail to your home address detailed information regarding COBRA and the forms required to complete to elect COBRA coverage.
Please note: Child's social security number must be listed in Workday to process COBRA paperwork.
- Workday Home, Menu, Benefits, Change: Dependent, Edit, scroll down to National ID
Other Options for insurance:If your child is working they may be able to enroll in their employer plan.
Or consider coverage through the State’s health plan options go to HealthCare.gov or www.mahealthconnector.org
Employee aging off a parent's plan and enrolling on a Brandeis plan
You must have proof of loss of coverage and documentation of the qualifying event from the parent's employer/insurer before the request can be approved. Documentation includes the following information:
- Loss of coverage reason
- Loss of coverage date
- Plan types ending
Workday Home, Menu, Benefits Change:Benefits, Reason: Loss of coverage
See Workday Job Aid
Updating Benefits-Qualifying Events to guide you through the process.
Divorced or getting divorced, separated what are the options?
If you lose coverage due divorce, separation or annulment that is a qualifying event to enroll on a Brandeis plan. You have up to 31 days to submit your Change Benefit request in Workday.
New Hires may enroll a divorced spouse your health plans if your divorce decree, states that you need to include them and neither of you are remarried.
If already enrolled you may keep a spouse on your plan after divorce as long as neither of you are remarried.
You can drop your spouse if they remarry or enroll in other coverage.
Documentation includes:
- Section of divorce decree or separation agreement that discusses health insurance.
- Marriage certificate (for whoever is remarrying)
- Proof of other coverage from their employer/insurer
To update demographic information for spouse:
- Workday Home, Menu (upper left corner), Benefits, Change: Dependents - select Edit next to their name, update the relationship status to ex-spouse.
- Remember to update the address as necessary.
To remove a spouse or ex-spouse from the health plans:
- You have up to 31 days to submit your change in Workday. Coverage end is retroactive to effective date.
- Divorce decree states you can remove them. Be sure they are aware you are removing them.
- You or ex-spouse gets other coverage or remarries.
Workday Home, Menu, Benefits Change:Benefits, Reason: Divorce
See Workday Job Aid
Updating Benefits-Qualifying Events to guide you through the process.
This is a two step process first enter date of death on their record and then remove from benefit plans and life insurance if a covered dependent or beneficiary.
Step 1
- On the Workday Home, Menu in the upper left-hand corner of your screen select the Benefits application.
- Select Dependents from the Change menu.
- Click the Edit button next to their name.
- Enter date of death
Documentation requested:
- Copy of death certificate or
- Obituary
Step 2
Once that is completed you can now start the Change Benefit process to remove them from your health and life insurance plans.
Workday Home, Menu, Benefits Change:Benefits, Reason: Death of spouse/dependent
See Workday Job Aid Updating Benefits-Qualifying Events to guide you through the process.
Arriving to the service area is a qualifying event to enroll yourself, spouse or child dependent to a plan.
Moving out of the service area for yourself, spouse or dependent is a qualifying event to change to a PPO plan or waive coverage.
You must submit your Change Benefit request and upload required documentation on Workday within 31 days of the event date. Coverage is retroactive to effective date.
Documentation includes the following information:
Within US
- Change of address documents for RMV or Post Office or
- Change of address confirmation for credit card or utilities
International
- Stamped Passport or
- Plane ticket/itinerary
Notify Benefits to launch the Service Area Change task to your Workday Inbox.
How to upload the documents directly to Workday
- Workday Home, View Profile, Personal: documents or
- Workday Home, Menu, Personal Information,View: worker documents
- Use Benefits as the document category
If adding spouse or dependents to your plan include:
- Marriage Certificate
- Birth Certificate for children
- Social Security Numbers
HPHC Service area: MA, RI, NH, ME, VT, parts of CT.
What happens with my benefits while on leave?
There are several types of leaves that are unique to a University. What happens with your benefits depends no the type of leave, the reason for the leave and whether it's paid or unpaid. While on leave of absence your health benefits may continue or you may elect to suspend them.
- Paid Leave: Benefits will continue unless you request a change.
- Unpaid Leave: Benefits will continue unless you request a change, however you are responsible for paying your premiums. Contact Benefits to discuss payment options.
If you are residing outside of the service area while on leave you may need to change to the PPO plan. See also Service Area Change
To initiate a benefits change related to a qualifying event, log into Workday; from the menu in the upper left corner choose Benefits, Change: Benefits, use the drop down menu to select the applicable Change Benefits qualifying event. Choose the appropriate date and upload your documentation.
Also see Job Aid Updating Benefits - Qualifying Events to guide you through the process.
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See our Workday Job Aid page for Updating Benefits-Qualifying Events to guide you through the process.
You have two chances to upload your documents on the qualifying event Change Benefit task
- The first is after you put in the effective date of your event the gray upload document window appears just above the Submit button. Your second chance is on the last page just before the signature section.
You can also upload documents separate from the Change Benefit task.
- Workday Home, View Profile, Personal: documents or
- Workday Home, Menu, Personal Information,View: worker documents
- Use Benefits as the document category
Open Enrollment
Open enrollment is the two-week period, usually in late October early November, when employees can update or change their medical, dental or vision plans, and enroll (or re-enroll) in the health care and/or dependent care flexible spending accounts. The changes take effect on Jan. 1.
During this period, human resources sponsors several benefits information sessions, both in person and online, to review the open enrollment process and discuss new benefit offerings for eligible faculty, staff and postdocs.
Open enrollment is done through Workday, the university's self-service portal. Human resources main communication is through InBreif, the email newsletter from Finance and Administration that posts every other week on Thursdays. We will also send Workday alerts during this period reminding employees of the opportunity to update or change their benefit plans.