Once you enroll as a new hire or during Annual Enrollment, you generally will not be able to change most of your benefits until the next Annual Enrollment, typically held each fall, unless you experience a Qualifying Life Event (QLE), as defined by the IRS.
A QLE is a change that affects your or an eligible dependent’s benefits eligibility. When you experience a QLE, you’re allowed to make certain changes to your current benefits. Any change in benefits must be consistent with the QLE. For example, if you get married, you may add your spouse (and any eligible dependent children) to your medical plan or cancel your medical coverage to join your spouse’s medical plan.
If you do not have a paycheck for a period (or the paycheck is insufficient), coverage will continue if elected, but employees are required to make up missed deductions out of future paychecks until the full amount has been repaid. The employer will not deduct more than two times the standard pay period benefit deduction from any paycheck.
If you experience a QLE during the year, you may make the associated changes to your current benefit elections by logging on to Benefits4MeEnroll.com. You must make any needed benefits changes within 31 days of your QLE, and you will need to show necessary supporting documentation (e.g., marriage certificate, birth certificate, etc.) within 31 days of the status change. Otherwise, you will have to wait until the next Annual Enrollment to make the change. Any change(s) you make will be retroactive to the date of the QLE.
Click here to access a chart that provides a high-level summary of the changes you can make based on each QLE. Use the accordions beneath the chart for additional information, including actions to take and considerations for programs and support.
Log in to Benefits4MeEnroll to process a QLE.
You have 31 days from the date of the QLE to make changes to your benefits. If you do not take action during this time, your coverage will continue as is and you may make changes during the next Annual Enrollment.
Need to update your name or address?
To update your last name and/or address in our system, visit HR4You and click on Employee Profile. You will need to provide supporting documentation, like an updated Social Security card to confirm your new name.
Don’t forget your documentation!
To add your new spouse or domestic partner to your benefits, you will need to show proof of eligibility, such as a marriage certificate or signed Affidavit of Domestic Partnership.
If your ex-spouse or domestic partner is covered through one of our medical plans, eligibility for our employer-provided coverage will end as of the end of the month of your divorce date. They may be eligible to continue coverage by enrolling through COBRA. If your ex-spouse or domestic partner has additional options for health coverage, they will want to compare those options and costs with what’s available through COBRA.
Be sure to notify Benefits4Me at Benefits4MeEnroll.com or call 844-279-7894 of your divorce, legal separation, or dissolution, and your ex-spouse or domestic partner will be notified about their right to elect COBRA. Update your ex-spouse’s or domestic partner’s address at Benefits4MeEnroll.com to ensure that COBRA information is sent to the correct location.
If you do not notify Benefits4Me of your divorce, legal separation, or dissolution and drop your ex-spouse or domestic partner from coverage, you may be responsible for paying any claims they incur after the split is finalized.
Complying with Qualified Medical Child Support Orders and Qualified Domestic Relations Orders
A Qualified Medical Child Support Order (QMCSO) is a federal law that gives children the right to receive benefits under group health plans. A QMCSO allows a custodial parent (the parent who has the child most of the time), who is not an employee of our organization, to obtain our health insurance for the child under the plan the non-custodial parent has with us.
A QMCSO is usually obtained via court order as part of the legal process associated with your divorce, legal separation, or dissolution. If this applies to your situation, once we receive the order, we will comply with its requirements. If you have any questions, a description of the procedures governing QMCSOs is available to you at no charge. Visit Benefits4MeEnroll.com for more information.
A Qualified Domestic Relations Order (QDRO) is a judgment as part of a divorce agreement that requires a retirement plan to pay child support, alimony, or marital property rights to an ex-spouse, child, or other dependent. If you have questions about or need assistance with filing a QDRO, contact our partners at QDRO Consultants through www.qdros.com.
Need to update your name or address?
To update your name and/or address on your benefits or in our system, visit your Employee Profile on HR4You. You’ll need to provide a legal document with your updated last name.
Don’t forget your documentation!
To update your benefits as part of this QLE, you will need to show proof of eligibility, such as a divorce decree, legal separation decree, or dissolution documentation.
There are several situations in which you, your spouse or domestic partner, or your child may gain or lose coverage. Examples of common situations include:
Gaining Coverage Elsewhere
There may be a time when you find yourself newly eligible for benefits coverage outside of our Company. For example, perhaps your spouse has started a new job, and you now have access to benefits coverage through their new employer.
Gaining coverage elsewhere doesn’t automatically mean you should make changes to your benefits or drop coverage through our Company in favor of what is now available. It’s important to carefully compare your new benefit options to those available through our Company to make the best decision for yourself and your loved ones. It also does not have to be an “all or nothing” change. You can choose to remain covered in our Company plan while you drop your spouse/domestic partner or child from your coverage and have them enroll in their employer’s plan. In addition, you may choose to change your medical coverage, but remain in our Company dental and vision, for example.
Losing Coverage Elsewhere
If you or your dependent is losing access to coverage from another source (for example, perhaps you were covered as a dependent on your spouse’s benefits, but they have left their job), compare our Company’s benefit options to what you or they may be entitled to receive through COBRA as a result of the loss. COBRA lets you continue your coverage for a specific period of time (typically 18 months). You’ll be responsible for paying 102% of the total cost. However, if your change occurs mid-year, COBRA honors any amounts you’ve incurred toward your annual deductible and out-of-pocket maximum. It’s legally required that the company from which you’ve lost coverage provides additional information on COBRA when you process your change. Each person affected will receive a COBRA notice.
If you or your dependent child is losing access to our Company coverage due to turning age 26, you will receive a COBRA notice to continue coverage. You can weigh your available options and choose the coverage that is the best fit.
Take Action
Don’t forget your documentation!
To enroll in benefits as part of this QLE, you will need to show proof of eligibility, such as proof that you or a dependent has lost coverage through another employer.
To drop benefits as a part of this QLE, you will need to provide proof of coverage consistent with your current enrollment elections.
Not providing documentation as needed may delay the approval process for the change.
On behalf of the Company, please accept our condolences.
You will also be contacted be our Life and AD&D Insurance administrator, Sun Life, if you were the beneficiary of a Company-sponsored or buy-up insurance policy through our Company’s benefits.
Watch your mailbox for additional information about your benefits, any actions you need to take, and information about enrolling in COBRA coverage.