Life Event Changes
A qualifying life status event is an IRS approved opportunity to add or remove yourself and/or your dependents from medical and dental insurance outside of the annual Open Enrollment period.
Qualifying Life Status Events
A qualified life status event is typically a time where you can either drop medical and/or dental coverage here at Dartmouth, or have an opportunity to enroll in medical and/or dental coverage elsewhere due to a major life event.
Qualilfied Life Status events usually consist of the birth or adoption of a child, a marriage or divorce, or when a dependent loses or gains a job with medical/dental coverage.
Most qualifying life status changes will only allow changes to certain benefits. The event used in FlexOnline will determine what benefits you can or can not add, change or cancel.
When adding or increasing benefits, changes take effect as of the date of the qualifying life status change. When canceling benefits, they end on the last day of the month in which the life event occurred.
IMPORTANT NOTICE: Qualified life events may cause changes to your monthly or biweekly payroll deductions. Depending on the nature of the change that you are making, retroactive premiums may be owed or credited back to you, based on the effective start date of this change. Benefits are paid in advance at Dartmouth, so if adjustments are required, they will be reflected accordingly in an upcoming paycheck. When adding coverage, you may owe multiple pay periods of premiums, so please be prepared.
Increasing or Decreasing Hours
If you are increasing hours and transitioning from non-benefits eligible to benefits eligible then you will have an opportunity to elect benefits as though you were a new hire and will be given 30 days from the date you become benefits eligible to make these elections in FlexOnline. If you are decreasing in hours to the point where you are losing benefits eligibility, then benefits will end on the last day of the month in which you are benefits eligible. If you are increasing or decreasing in hours and are already benefits eligible, you may not make changes to your existing benefit elections.
If you are unsure of your annual salary and full time equivalancy used to calculate your benefits, please reach out to the Benefits Office.
Types of Events
Changes to Medical Insurance
Changes to Dental Insurance
Changes to Life Insurance
Changes to Long Term Disability Insurance
Changes to Flexible Spending Accounts
Changes to Health Savings Accounts
Changes to your Retirement Elections
Event Change Status Information
Other Life Event Scenarios
Completing a Life Event in FlexOnline
Your request must be submitted through the FlexOnline system within 30 days of the date of the event. Changes submitted 31 or more days from the date of the life status change, may be denied and may only be made during the Open Enrollment period for a January 1st start date. Please be sure to complete the event and upload your event and dependent verification.
- Birth/Adoption/Legal Guardianship-Use this event if you have had a baby, legally adopted a child or had a child placed with you for adoption or legal guardianship within the last 30 days and need to add them to your medical and/or dental benefits. Event verification and dependent verification will be required.
- Marriage-Use this event if you have recent gotten married within the last 30 days and are adding a spouse and dependents to your medical and/or dental benefits. Event verification and dependent verification will be required.
- Divorce-Use this event if you have recently become divorced within the last 30 days and need to remove dependents from coverage.
- Employee Gains Eligibility for Outside Coverage-Use this event if YOU have gained eligibility to take medical and/or dental coverage under another source and need to drop coverage under Dartmouth. Dependents may also be dropped, but if only dropping dependents please see Dependent Gains Eligibility for Outside Coverage below. Event verification will be required.
- Employee Loses Eligibility for Outside Coverage-Use this event if YOU have lost coverage under another source and need to add yourself to coverage under one of Dartmouth medical and/or dental plan(s). Dependents may also be added, but if only adding dependents please see Dependent Loses Eligibility for Outside Coverage event below. Event verification and dependent verification will be required.
- Dependent Gains Eligibility for Outside Coverage-Use this event if your DEPENDENT(s) have gained eligibility to take medical and/or dental coverage under another source and they need to drop your Dartmouth coverage. Do not use this event if YOU are also looking to drop coverage, please see Employee Gains Eligibility for Outside Coverage above. Event verification will be required.
- Dependent Loses Eligibility for Outside Coverage-Use this event if your DEPENDENT(s) have lost coverage under another source and you need to add them to your existing medical and/or dental coverage. Do not use this event if YOU are looking to also enroll in coverage, please see Employee Loses Eligibility for Outside Coverage above. Event verification and dependent verification will be required.
- CHIP/Loss or gain of Medicaid for Children-This is not an event found in FlexOnline, but loss or gain of Medicaid coverage for children is considered a qualified life event for adding or removing your children from your medical and/or dental insurance. You would then be able to complete a Dependent Gains or Dependent Loses Eligibility for Outside coverage, as described above.
- Health Savings Account Change-Use this event if you wish to increase, decrease, start or stop your annual health savings account contributions. Please be sure to review the Changes to Health Savings Accounts section below.
- Dependent Care Flexible Spending Account Change-This event is not shown in the FlexOnline system. If you have had a major change to your Daycare, Summer Camp, After School program status, please reach out to the benefits office to discuss the change. In some cases we may be able to make a change to your anual contribution amount with event verification. See Who to Contact with Questions below.
- Employee/Dependent Gains Medicare Eligibility-When you and/or your spouse become eligible for Medicare, you have an option of enrolling in Medicare Parts A & B. This can be considered a qualified life event for dropping medical coverage for yourself and or your spouse. Please refer to our Retiree Health webpage for more information about turning age 65
- Death of Spouse or Child-Please reach out to The Benefits Office if you experience the loss of a spouse or a child and we will take care of removing them from coverage for you. We will also determine whether you had them covered under a dependent life insurance plan and will begin the process of completing the claim for you.
- Qualified Medical Child Support Order (QMCSO)-If you are required to add a child to your medical plan due to a Qualified Medical Child Support Order, this would be considered a qualified life event, and would be added as a Dependent Loses Outside Coverage event described above.
The idea is to maintain fluidity in your health and dental coverage, so that no gaps in coverage occur.
Adding Yourself or Dependents to Coverage: When adding yourself or dependents to a medical or dental plan, coverage begins as of the event date. To avoid gaps in coverage, use the day after your last date of outside coverage as your event date. For example, if the last day of your former coverage was on the 15th of the month, use the 16th as your event date.
Removing Yourself and/or Dependents from Coverage: When removing yourself and/or dependents from your medical or dental plan, coverage ends on the last day of the month. To avoid gaps in coverage, use the day before your new coverage is scheduled to begin as your event date. For example, if your new coverage is scheduled to begin on July 1st, use June 30th as the event date, and coverage will stop on July 1st. If you use July 1st as the event date, coverage will not end until July 31st.
Coordinating dates with other health plans: It is important to coordinate start/end dates with your new/former health/dental plan. For example, if you get married on 15th of July and want to add your spouse to your medical plan. Your spouse will need to find out whether their current coverage will drop on the 15th (the day you got married) or at the end of the month. If your spouse's coverage ends on the 15th, then you would use the "Marriage" life event option with an event date of July 15th and you will need to upload your marriage certificate as your event verification. But if your spouse's coverage doesn't end until the end of July, then your spouse uses Marriage as their reason for dropping coverage through their employer and you would use the "Dependent Loses Outside Coverage" option with the 1st of August as your event date, because that is the first day that your new spouse will be covered under your plan. You will then need to obtain a letter from your spouse's employer indicating that your spouse is being dropped from their coverage and their last date of coverage on the plan.
In this example, if your spouse's coverage did not end until the 31st and you completed a Marriage event dated the 15th, your spouse would be double covered for the second half of the month; both through your Dartmouth plan and their employers plan.
If you are adding a spouse to your medical or dental plans, you will need to upload a copy of your marriage certificate as dependent verification, if you do not have a copy of your marriage certificate, a copy of a joint tax form could be used.
If you are adding a dependent child, then a birth certificate or court document showing proof of guardianship should be uploaded as your dependent verification.
When gaining or losing outiside coverage, you may submit a letter from your dependent's employer, a copy of a new ID card or a print screen from the insurance company's employee portal. Your documentation must show all of the following pieces of information:
1. On employer letterhead or show name of insurance carrier.
2. Full names of all impacted family members including employee, spouse and/or children
3. Date that outside coverage is ending or starting.
4. Type of coverage that is being lost or gained (i.e. medical or dental)
In general, you should be careful about chaning medical plans mid-year (ex: From OAP to HDHP) unless you end employment and are rehired within the same year. Your deductibles and out-of-pocket accruals met year to date will not transfer to the plan so this could potentially cost more out-of-pocket, than the savings in premiums. You could also put yourself at risk with the IRS if you are changing contributions from Flexible Spending Accounts and Health Reimbursement Accounts to Health Savings Account or vise versa. We recommend that you contact a tax professional to make sure you remain compliant with IRS regulations in these cases.
If you have a spouse who also works at Dartmouth, you may transfer from their plan to your own or vise-versa during a qualifying life status event, however you may face the issues switching between plans mid year as mentioned above (ex: OAP to HDHP). Be sure to contact Cigna at 855-869-8619 and ask for the balances to be transferred to your new plan.
When making changes to your medical plan, we encourage you to refill all prescriptions just prior to the change, to ensure that you have enough medication to last through the transition period. You may need to ask your provider to submit a new prescription for this to be approved by the pharmacy. Most pharmacies will reimburse overpayment when requested within 14 days of the refill. After 14 days, Express Scripts and most other Pharmacy vendors will only reimburse at the prescriptions allowable amount. If you have an emergency situation, please reach out to the benefits office for assistance.
You may only add or remove dependents during a qualifying life status event.
Some qualifying life events will allow changes to your life insurance coverage. However, you be required to submit for Evidence of Insurability. Once you complete your qualifying event, check your notifications section for a "Pending EOI" notification. If required, click and follow the prompts. You will not be billed for the change until the increase in coverage has been approved by Lincoln Financial.
You may not complete a status change event to only change life insurance benefits, the change must be related to a change in medical or dental coverage as well.
During a qualifying life status event, you will only have the option to drop Long Term Disability insurance.
Some qualifying life status events will allow changes to your Flexible Spending Accounts. The ability to increase or decrease follows the nature of the event. When making a change to your FSA, you can never decrease your balance below the amount that has already been contributed year to date. When increasing your annual amount, you can only use the additional amount on expenses incurred after the date of your event.
Note: If you are making a change within 10 days of your next paycheck, the change may not occur until the following paycheck.
Employees may make changes to their Health Savings Accounts at any time without an actual life event. When making a change to your HSA, you can never decrease your balance below the amount that has already been contributed year to date. If you have not yet contributed to an HSA account, and want to start contributing now, your funds will not be deducted until we have confirmed that you have claimed your account with Fidelity.
Note: If you are making the change within 10 days of your next paycheck, the change may not occur until the following paycheck.
Changes to your retirement elections may be made at any time through http://dartgo.org/retirement. On the left side of the screen you will click on ACCRESS YOUR RETIREMENT AND HSA ACCOUNTS HERE icon. Use the HOW TO GUIDE found below for illustrated instructions on how to make changes to your contribution elections, found below the CLICK HERE TO LOGIN button.
Note: Although this platform is run by Fidelity, those with contributions in TIAA may also access and change their retirement contributions through this site.
Note: If you are making the change within 10 days of your next paycheck, the change may not occur until the following paycheck.
Submitted & Approved
Please allow 3-5 business days for your event documentation to be reviewed. You will receive an email to your Dartmouth email address letting you know whether the event was approved or denied. Once approved, please allow an additional 7-10 days for your changes to appear through the insurance vendor portals.
Changes entered less than 10 days prior to a pay date may not appear until the second pay period following your event completion. For example, if you enter your change on March 25th, and are monthly paid, you may not see the premium changes until your May 1st paycheck. Arrears and credits may take up to 14 days to process.
Events are most often denied because the dates on your event verification document do not match the date that you used for your event date. However, please do not run a new event, please reach out to the benefits office and we can help you create the new event and remove any old events.
If this is not the reason for your denial, or if you are unsure why your event was denied, please submit a written request for review to the Benefits Office explaining the circumstances surrounding your life event and what you were trying to change and we will research your event and find out why it was denied and what if anything can be done.
If Spouse is also a Dartmouth employee:
- In some instances, you and your spouse may both be benefits eligible Dartmouth employees. If you have an event and are looking to switch from one spouse's insurance to the others, then you must each change your benefits through FlexOnline.
Dependent child is turning age 26:
- Dependent children turning age 26 will automatically be removed from your medical, dental and dependent life insurance plan(s), at the end of the month in which they turned age 26. (Example: If your child turns 26 on July 1st, their last day of coverage(s) will be July 31st. i.e. they will no longer have coverage on August 1st).
- Notification will be sent to Sentinel Benefits. Their COBRA packet will be mailed to the employee's address on file within 2 weeks AFTER their last day of coverage.
- If the removal of a dependent causes a tier change or decrease in your insurance premiums, a credit will be applied in a future paycheck. If your dependent child is age 26 or older and falls under disabled status (enrolled in SSDI), please contact the benefits office at (603) 646-3588.
- In the case of a divorce, it is the employee's responsibility to remove the former spouse from their plan within 30 days of the divorce finalization date. Keeping in mind that benefits for the spouse will end on the last day of the month in which the divorce event occurrs. You would complete this event by logging into the FlexOnline system and following the steps listed above for the qualifying life status event. Dartmouth does not cover divorced spouses or their dependents, so they will be offered COBRA benefits at the full premium rate plus a 2% administration fee. COBRA packets will be mailed to the employee's address unless a forwarding address is provided to Crosby Benefits or the Benefits office prior to the mailing of the packet. Please refer to the Leaving Dartmouth web page for costs and more information on COBRA. If you are responsible for paying premiums on a divorced spouse, it will be at the COBRA rate. Important Note: Please be sure to notify your spouse prior to dropping their medical coverage.