Throughout life, there are many milestones an individual experiences along the way. Some are planned and others come as a surprise, and almost always these events are the source of change, anxiety, or stress. In the insurance world, these milestones are often referred to as qualifying life events.
“One of the most important things pertaining to qualifying life events is simply paying attention,” said Christine Boles, Director of Human Resources at PHP. “It can be easy to get caught up in the moment, so having the awareness to both recognize and understand how the life event may affect your health insurance coverage is crucial. Even if an event doesn’t currently apply to you, it could apply to you tomorrow.”
When experiencing a qualifying life event, it’s important to understand how it may affect your health insurance coverage. There’s a wide array of life events and in the midst of the event itself, you will have a thousand other things on your mind. Knowing ahead of time what these events are and what action you should take is essential for you and dependents on your health plan.
Marriage
Notify your employer within 31 days of the getting married in order to cover your new spouse from the wedding date. Your employer may require a copy of the marriage license.
Birth/Adoption
Notify your employer within 31 days of the birth or adoption of your child, as coverage is not automatically instituted from medical claims of the hospital stay of the mother. You should do this as soon as you can, waiting for a social security number may cause you to miss a deadline. If using self-service technology, the system may ask for a SSN but some allow you to bypass that field or have a box to check indicating you have applied for the SSN. Your employer may require a copy of the birth certificate or adoption order.
Moving Day
Always make sure your employer and your health insurance company have an up-to-date mailing address. Often, you can update your address online in your health plan member account or by calling customer service.
Dependent Status
Coverage is available for eligible dependents up to age 26. Once a covered dependent reaches age 26, see your human resources department for details about continuing medical coverage.
First Day of Work
You must apply for or enroll in employee benefits within a specified time period set by your employer. See your employer about the process, paperwork, and timing to complete the appropriate paperwork.
Medicare Eligibility
If you are age 65 or over, Medicare eligibility likely doesn’t change eligibility for coverage under your employer’s plan. However, Medicare may provide additional benefits or impact benefits of your employer health plan.
Loss of Coverage
Generally, loss of other insurance coverage is a qualifying life event to enroll in your company’s benefits but only if the application is made within 31 days of having lost that coverage.
Divorce or Death
Notify your employer of any changes or updates to life insurance beneficiary information within 31 days of a divorce being final or the loss of a family member.
Additional Information
If you have questions regarding qualifying life events, be sure to consult your HR department or health insurance company for more information.
