What is a Qualifying Life Event?
The following are examples of common qualifying life events (QLEs) that allow eligible workers to enroll or make changes to their coverage, including adding dependents, outside of their company's Open Enrollment period.
This page contains the most common examples of QLEs. This is not intended to be an exhaustive list, and does not contain examples for every available QLE situation.
Some qualifying life events also act like open enrollment for the whole family. For example, if an employee that is not enrolled in benefits has a baby, the employee can enroll themselves, their spouse, and all eligible dependents as well. Eligible dependents can take advantage of a qualifying life event to modify or elect new coverage. They can also cancel their plan coverage if a qualifying life event occurs.
Having a baby or adopting a child
Getting married or divorced
A dependent losing coverage due to turning 26
Example: An employee has their 26th birthday on September 27th, however the coverage remains active through the end of September. The coverage cancels on September 30th, and employee can enroll in their employer's group coverage within 27 days for an October 1st effective date.
Change in employment status
- Quitting a job or being laid off.
- Moving from part-time to full time.
This is a loss of coverage QLE and the effective date for coverage will be backdated to the date that the coverage officially terminated.
Moving to the USAIf an eligible worker and their dependent(s) move into the US from outside of the country, they are able to join a plan under a QLE if they can show their passport stamp within 30 days of arrival. This must be completed within 27 days in the Zenefits system to allow for processing time.
Loss of a dependent
Spouse Open EnrollmentA spouse going through open enrollment counts as a qualifying life event. For example, if a spouse chooses to decline coverage through their company's open enrollment, they can be added as a dependent to the employee's plan in Zenefits.
Declining Marketplace InsuranceDeclining individual marketplace open enrollment coverage is considered a qualifying life event to enroll in company coverage by many carriers. Please contact your insurance carrier for final confirmation on whether it is considered a QLE.
If you are a worker experiencing a qualifying life event, follow these instructions to update your benefits coverage.
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