Overview/Eligibility
The Internal Revenue Service (IRS) limits when employees can add coverage for dependents or make changes to healthcare and flexible spending accounts during the year. Individuals have the following opportunities to elect or make changes to their benefits:
- During the Annual Benefits Open Enrollment period in the fall (changes effective January 1 of the following year)
- Within 31 days, or 90 days for the birth or adoption of a child, of a Qualifying Life Event listed below
For more information, review the Notice of Special Enrollment Rights.
Qualifying Status Event Changes
- Marriage or divorce
- Birth or adoption of a child
- Death of a spouse or child
- Loss or gain of benefits eligibility for employee, spouse, or child
- Transition from full-time to part-time status, or vice versa, that changes benefits eligibility for employee or spouse.
- Employee or a spouse take or return from an unpaid leave of absence
- Any significant change in a family’s healthcare plan coverage through a spouse’s healthcare plan
Deadlines & Application Process
- Employees experiencing a Qualifying Life Event must log in to HR Self Service to make changes to coverage within 31 days, or 90 days for the birth or adoption of a child, of the date of the life event. If not done by the deadline, the change cannot be made until the next open enrollment period.
- Employees log in to HR Self Service, select Benefit Details and then Life Events. If the needed life event is not listed, contact the Benefits Team.
- Since these changes must comply with IRS regulations, employees must provide proper documentation for the change, such as a birth certificate or divorce decree, and the benefits changes must be consistent with the nature of the life event.
Changes Permitted During the Year Without A Qualifying Life Event
- Elect or change beneficiary designations
- Elect, change, or waive coverage under supplemental, spousal, or child life insurance—evidence of insurability (EOI) form required when electing or increasing the supplemental and spousal life insurance coverage
- Elect, change, or terminate long term care coverage—EOI required when electing or increasing coverage
- Elect, change, or terminate participation in the Retirement Savings Plan
- Elect, change, or terminate the Health Savings Account (HSA) if enrolled in the CDHP
Updating Your Beneficiary
When experiencing a life event, it is a good time to review life and TIAA retirement plan beneficiary designations. Life event changes do not automatically change beneficiary designations. Employees may review and/or update their life insurance beneficiary information in HR Self Service. Contact TIAA to review and/or update retirement plan beneficiary information.
Rules
- Changes for life events are effective first day of the month coincident with or next following the date of the event.
- Changes to benefit plans must be consistent with the life event and correspond with a gain or loss of eligibility for coverage. For example, marriage is a change in which employees may add their spouse to current coverage, but cannot enroll in the vision plan not previously elected.
- Changing a Flexible Spending Account amount retroactively that crosses a calendar year is not permitted. For example, although an employee may elect or increase the Flexible Spending Account due to the birth of a baby born on October 20, the employee cannot elect this increase after the December payroll closes. Once the tax year has ended, retroactive elections cannot be made.
- A qualifying event does not allow an employee to switch their plan mid-year; for example, switching from the HMO Plan to the Princeton Health Plan is not permitted.