**IMPORTANT** Information provided is intended solely as a guide and is a partial listing of eligible events and corresponding changes. If you have experienced or anticipate experiencing a qualified Life Event change you must notify Human Resources, in writing, within 31 days of the date of the event. For more information, contact Human Resources directly.
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Benefits Election Change Form / Declaration for Change Form (Life Event Change)
(PDF)
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| Status Change | Sample Changes Permitted | Sample Changes NOT Permitted | Documentation Required? |
Employment hours reduced for employee (assumes loss of eligibility)
Switch from full-time to part-time
Strike or lock out
Commencement of unpaid leave |
Elect coverage under spouse's plan (or employee's plan if spouse reduced hours and lost coverage) |
Change health option |
Yes, if requested change is due to change in work schedule of spouse or dependent and they are not a University employee
Verification of loss of coverage (i.e. COBRA letter) |
Employment hours increased for employee (assumes newly eligible)
Switch from part-time to full-time
Return from strike or lock out |
Elect newly eligible plan (or drop coverage if spouse increased hours and added coverage) |
Change health option |
Yes, if requested change is due to change in work schedule of spouse or dependent and they are not a University employee (letter from spouse's or dependent's employer indicating new coverage) |
| Return from unpaid leave |
Re-elect previous coverage |
Elect new coverage |
No |
