Qualifying Life Events
Qualifying Life Events (Q.L.E) are situation that allow you to enroll a dependent under your district coverage or end coverage for a dependent that is under your district coverage outside of the open enrollment period. There is a 30 day window in which you MUST complete all paperwork that is related to your QLE. If it is not done within 30 days from the date of the event, you have to wait until open enrollment.
Qualifying Life Events would be:
Marriage
Divorce
Birth/Adoption or Guardianship
Loss of health insurance coverage from an outside plan (i.e. you had coverage from another source and lost that coverage, you are turning 26 years old and aging off of your parent(s) coverage)
Please be advised, you CANNOT change your current plan, you can only add/drop dependents.
Open Enrollment is held every November and is the only time you may elect to change your plan. It is also the time when you can add dependents that were not added within 30 days of the event such as marriage or loss of insurance.
The Benefits Office must be notified within 30 days of any life-changing event. Informational packets, complete with the necessary forms, are available by clicking on the hyperlinks below.
Please read the information with the packets thoroughly. If the forms are not filled out correctly or completely, this will hold up the process. (This includes life insurance forms and change of name, address, etc.). If documentation is missing from your packet, this will also hold up the process.
See below for the paperwork that aligns with each QLE:
Divorce – your former spouse (and stepchildren, if applicable) becomes ineligible for the District health insurance plan on the date of your divorce. Under no circumstances is the District liable to provide coverage for your former spouse, even if the coverage exceeds the date of divorce. COBRA is the available option for the former spouse to continue insurance, if necessary. Your Divorce decree MUST be included with your paperwork, specifically the 1st page, page that includes any agreement for health insurance and the last page. Be sure to update your life insurance beneficiary if needed. Please be advised, you CANNOT change your current plan, you can only drop dependents. This MUST be done within 30 days from the date of the divorce.
Marriage - your new spouse (and stepchildren, if applicable) becomes eligible for the District health insurance plan on the date of your marriage. It is your responsibility to notify the Benefits Office, complete appropriate paperwork and submit documentation within 30 days of the date of your marriage. Please be advised, you CANNOT change your current plan, you can only add dependents. This MUST be done 30 days from the date of your marriage. If it is outside the 30 day window, you will have to wait until open enrollment to add new dependents.
Waiver Form - If you are receiving health insurance coverage from another source then you are eligible to participate in the Waiver Program, which entitles you to $100 per month in-lieu of health insurance for BCSA, PCTEA, Exempt and Local 264. If you are a member of BTF, the waiver entitles you you to $250 per month in-lieu of health insurance. This benefit is time-sensitive and not retroactive. There is one annual payment in the month of January for the previous years' participation.
If you are married to a Board of Education Employee you are only eligible for one family policy. The employee not enrolled in health insurance may take advantage of the Waiver Program
Birth/Adoption/Guardianship - your child becomes eligible for the District health insurance plan on the date of its birth. It is your responsibility to notify the Benefits Office and complete appropriate paperwork within 30 days of your child's birth. We understand that you will not have a birth certificate and social security card(s) right away, however, a letter from the hospital for proof of birth is required to be submitted with the enrollment form. Copies/photos of the child's birth certificate and social security cards must be turned into the Benefits Office as soon as they are received (may exceed the 30-day deadline if the processing is slow). Please be advised, you CANNOT change your current plan, you can only add dependents.
Loss of insurance by eligible dependent - your dependent becomes eligible for the District health insurance plan effective the date of loss by another source. It is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of loss of insurance. If documentation is not submitted within 30 days from the date they lost coverage elsewhere, you will not be able to add them until open enrollment.
Employee Turning 26 and Aging off Parent's Insurance - Employees who turn 26 age off of their parent's plan the first day of the month after their birthday. It is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of loss of insurance. (Please use the new hire packet associated with your union, found at Benefits , to learn about your health insurance choices and complete and submit enrollment form from your union's packet).
Remove Dependent - Has Their Own Insurance - For employees whose dependents turn 26, the district will automatically cancel their insurance effective the last day of their birth month, and send COBRA and NYS Marketplace information via US Postal Service. Please be sure to notify the Benefits Office if your coverage will change from family to single due to a dependent turning 26. The information with COBRA and the NYS Marketplace will be addressed to the dependent who is aging off.
If your dependent obtains health insurance through another source, it is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of obtaining insurance.
Death of a Dependent - While we understand that this is a very difficult time should you experience the unfortunate loss of a covered dependent, there are forms that must be completed to update your records.
RELATED FILES