|
|
Change in Work Schedule
**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.
 |
Benefits Election Change Form / Declaration for Change Form (Life Event Change)
(PDF)
|
|
| 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 |
Employment commencement
(i.e. spouse begins employment or obtains new coverage) |
Elect coverage under spouse's plan and drop under employee's plan |
Change health option
Drop coverage, but not elect under spouse's plan |
Yes, Verification of new coverage enrollment |
Terminate employment
(i.e. if spouse terminates employment) |
Elect coverage under employee's plan
Increase flex spending |
Change state health plan |
Yes, Verification of loss of coverage (i.e. COBRA letter) |
|
|
|
| Who To Contact |
Rates |
FAQ's |
|
|
|
|
|
|
|
© 2005, Arizona Board of Regents
University of Arizona | University Services Building, 888 N. Euclid Avenue, Room 114, Tucson, AZ 85721-0158
520.621.3662 (phone) | 520.621.9098 (fax) | Page last updated June 12, 2007
