Qualifying Change in Status
About Qualifying Change in Status Events
The UNM-sponsored group health plans have a pre-tax status and are, therefore, governed by IRS regulations. Once you in enroll in coverage for medical, dental, vision, or a Flexible Spending Account, you cannot make changes* to these plans outside of the annual Open Enrollment period, unless you experience a Qualifying Change in Status Event (also knowns as a Qualifying Life Event).
Changes to your coverage must be made within 60 calendar days of the Qualifying Change in Status Event by submitting your Enrollment Change Form(s) to UNM’s Benefits & Employee Wellness Department via (choose one):
- Secure Document Submission Upload at https://hr.unm.edu/secure-upload
- or fax to 505-277-2278.
- You may also submit it to the UNM HR Service Center, located at 1700 Lomas Blvd NE, Suite 1400.
See “Important Note” below.
Qualifying Change in Status Events include but are not limited to the following. Keep in mind that the change in benefits you are seeking must match the event that occurred. A change in one type of event may not allow for a change in other benefit elections. For example, if you have a child, you may not use that event to also discontinue dental coverage for a spouse.
- Birth, adoption, or gain of legal guardianship
- Marriage
- Divorce, legal separation, or annulment of marriage
- Death of employee, or of spouse or dependent
- The 26th birthday of your unmarried mentally or physically disabled child (an extension of coverage must be submitted)
- Employee or spouse employment change from part-time to full-time, or full-time to part-time, resulting in a change in eligibility
- Employee or spouse significant health coverage change attributable to spouse's employment
- Employment termination or commencement for the employee, a spouse, or a dependent
- Gain or Loss of other health coverage (including HealthCare Exchange coverage)
- Dissolution of qualified domestic partnership
Use the Qualifying Change In Status Event: Required Support Documentation guide to help identify documents you may have that demonstrate the event you have experienced from the list above.
IMPORTANT NOTE:
It is critical that you submit your Enrollment Change Form(s) within 60-calendar days of your Qualifying Change in Status Event, even if you are still waiting for your supporting documentation of the event (i.e. birth certificate/proof of birth, proof of loss/gain of other coverage from the other insurance entity, marriage certificate etc.).
Do not wait for your documentation or you risk missing your 60-calendar day deadline.
For assistance, go to the HR Contact List for direct links to your designated HR Technician
You may also call 505.277.6947 or email hrbenefits@unm.edu.
How to Make Benefits Changes
- Complete the form required for the benefit you are updating:
- Submit the form to Benefits & Employee Wellness within the required 60 calendar days of the Qualifying Event occurring. (See “ Important Note” above)
- Once your request has been received and approved by Benefits & Employee Wellness, your benefits election changes are effective as follows:
- Any change in coverage will become effective on the first day of the month following enrollment. For medical coverage only, you may choose to make coverage effective the date of enrollment, in which case premiums are not prorated for the month and you will pay the employee portion of the premium for the entire month irrespective of the effective date of coverage.
The only exception of election changes is in the event of a birth, adoption, or placement for adoption of a child. If this occurs, the medical coverage is effective retroactively to the date of birth, adoption, or placement for adoption.
Dependent Information
Adding a Dependent
If you are adding a dependent, you must add your dependent within 60 calendar days from date of the Qualifying Event and you will be required to provide proof documents within 31 days of your enrollment request (reference “ Important Note” above). Please note that it is your responsibility to be sure that all the dependents you enroll and continue to cover are eligible for benefits in accordance with the terms and conditions of the plan.
Provide copies of proof documents to Benefits & Employee Wellness via upload to the Secure Document Submission upload portal or fax to 505-277-2278. You may also submit documentation to the UNM HR Service Center, located at 1700 Lomas Blvd NE, Suite 1400.
See the Proof Documents Submission Requirements information sheet for a summary of what is required for those that are newly benefits eligible versus those who qualify for a change in status.
Removing a Dependent
It is your responsibility to dis-enroll your dependent within 60 calendar days of a qualifying event (see “ Important Note” above). Otherwise, you may be liable for any claims incurred by the ineligible dependent. In most cases, a dependent may be eligible to continue insurance coverage through the provisions of COBRA. Keep in mind that a dependent loses eligibility to participate in UNM sponsored plans if any of the following qualifying events occur:
- Dependent child turns 26 (coverage ends at the end of the month of your child’s 26th birthday)
- Divorce from a spouse
- Dissolution of a domestic partnership
To dis-enroll your dependent, you must submit election changes via the Enrollment/Change Form and provide supporting documentation.
Contact Information
Benefits & Employee Wellness
505.277.6947hrbenefits@unm.edu
See HR Contact List for direct links to your designated Sr HR Technician
If you need language assistance, please know that UNM is compliant with the Affordable Care Act and its provision regarding Nondiscrimination and Language Assistance.