There's a lot on the minds of your employees during open enrollment season. New plans, dates, deadlines, out-of-pocket expenses and other unfamiliar jargon are all up for reexamination. Employee benefits enrollment can be an overwhelming process, but it doesn't have to be. To help your employees through a smooth enrollment process, provide them with explanations of what certain terminology means so they feel fully in the driver's seat. While this won’t apply to all of your employees, offering information about Qualifying Life Events, or QLEs, will be helpful should an employee have experienced a major life change and need to make modifications to their benefits plan outside of the company's open enrollment cycle. Continue reading for a breakdown of the types of QLEs, how to provide proof of said change, and steps needed to take in order to make adjustments during a special enrollment period.
Open enrollment is the 45-day window where employees have the opportunity to sign up for coverage or make modifications to their existing healthcare coverage through their employer. Open enrollment is a crucial time to be prepared for, as employees want to ensure they’re happy with their current plan or that they have an idea for adjustments they'd like to make. It can take part at any time of year, really, but typically, most employers commence their OE during the fall months.
A special enrollment period (SEP) is a timeframe in which an employee can modify their current enrollment selections to adjust for any change that may have occurred. Typically, individuals have 60 days to make adjustments to their coverage following the QLE date.
If any of your employees have experienced any of the following qualifying life events recently, they're eligible to make changes to their existing benefits plan.
Undergoing a change in employment status that includes:
This is a loss of coverage QLE and the effective date for coverage will be backdated to the date that the coverage officially terminated. This applies to both an employee or their dependent.
If an employees decide to quit their job, that would trigger a special enrollment period for them that would allow them to enroll in their state's health insurance marketplace.
Yes — if an employee's spouse experiences a change in their employment, this counts as a qualifying life event. The employee must add their spouse within 31 days of the spouse's loss of coverage.
Typically, you will have 60 days from the date of the QLE to make amendments to your current benefits plan. So, if you turned 26 on April 25th, 2022, that is the date that commences your 60 day window to make selections in your new benefits plan. If you got married on May 1, the same applies.
Yes. When you join a new employer, you will go through an onboarding process that will allow you to make selections based on your current needs. If you plan to be a dependent on your parents' plan or that of a spouse, you can decline coverage at this time. If you qualify for a special enrollment period based on the qualifications above, contact your HR department to understand how you can commence making changes based off of your QLE.