1. What is a Qualified Midyear Change?
2. Time frame for making benefit changes because of a Qualified Status Change (QSC)
3. Making changes to health and optional insurance – Forms
4. Effective Date of Changes
5. Tobacco Use Program – Status Change
6. Additional Resources
Some life events qualify for changes in your plan choices and coverage levels after the start of the plan year and/or for new hires, after the initial new hire enrollment period. These are often referred to as Qualifying Status Changes (QSC). Examples of Qualified Status Changes include:
You have 30 days from the “event date” (i.e., birth, marriage) to make changes to your plan elections. You must complete and submit the applicable change forms to the benefits office within 30 days of the qualifying event.
Complete and submit the appropriate forms within 30 days of the qualifying event.
Based on the event, you may need to submit several forms (i.e., adding a grandchild by affidavit). The applicable change forms are located on the PEBB Forms webpage under the following sections:
Return completed form(s) to Employee Benefits:
*When adding a new spouse or domestic partner, you can enroll in the Optional Spouse/Partner Life Insurance and get the guaranteed issue amount of $20,000 without having to complete a health history statement and/or blood work. Any amount above the guaranteed issue amount would require the health history statement and possible blood work.
Changes to coverage goes into effect the first of the month following receipt of the midyear change forms, except for:
Your status in the Tobacco-use Program may change during the year. For example, you or your spouse/domestic partner may quit using tobacco, or a medical provider could advise you not to try to quit using tobacco. These changes allow you to end the related monthly deduction for tobacco use.
Submit the Tobacco-use Program Midyear Change form to Employee Benefits within 30 days.
If the form is received by the 15th of the month, it will be processed in that month's payroll and the deduction will end with the start of the following month. If the form is received after the 15th of the month, it will be processed in the next month's payroll, and the deduction will end with the start of the month that follows.
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