To Benefits
To Benefits for Employees

Qualifying Life Events

A Qualifying Life Event (QLE) allows you to add or remove dependents from your District health coverage outside of Open Enrollment.

You must submit all required forms within 30 days of the event. If you miss this deadline, you must wait until Open Enrollment.

Common QLEs

  • Marriage

  • Divorce

  • Birth, adoption, or guardianship

  • Loss of other health insurance (e.g., loss of outside coverage or turning age 26)

Important:
You may only add or remove dependents during a QLE. You cannot change your health plan.

Open Enrollment

  • Held each November

  • The only time you can change your health plan

  • Also allows you to add dependents if you missed the 30-day QLE window

30-Day Requirement

You must notify the Benefits Office and submit all paperwork within 30 days of the event.
Incomplete or missing forms and documentation will delay processing.

QLE Details & Requirements:

Marriage -

  • Spouse (and stepchildren) become eligible on the date of marriage

  • Submit paperwork within 30 days

  • You may only add dependents, not change plans

Divorce –

  • Former spouse (and stepchildren) lose eligibility on the divorce date

  • Submit paperwork within 30 days

  • Include divorce decree (first page, insurance section, and last page)

  • COBRA may be available for continued coverage

  • Update life insurance beneficiaries if needed

  • You may only remove dependents, you may not change plans

Birth/Adoption/Guardianship -

  • Child is eligible on date of birth/adoption

  • Submit forms within 30 days

  • Provide hospital proof of birth initially

  • Birth certificate and Social Security card must be submitted when available

  • You may only add dependents, you may not change plans

Loss of insurance by eligible dependent -

  • Dependent becomes eligible when other coverage ends

  • Submit forms and proof of loss within 30 days

Employee Turning 26 and Aging off Parent's Insurance -

  • Coverage under a parent ends the first day of the month after the 26th birthday

  • Submit enrollment forms within 30 days

  • Use your union’s hire packet to enroll, click here to enroll HERE

Remove Dependent - Has Their Own Insurance - 

  • Dependents turning 26 are automatically removed at the end of their birth month

  • COBRA and NYS Marketplace information will be sent to them

  • Notify Benefits if your coverage changes (e.g., family to single)

If a dependent gains other coverage, you must report it within 30 days.

Death of a Dependent -

  • Notify the Benefits Office and complete required forms to update records

Waiver Form -

If you have health insurance elsewhere, you may waive District coverage and receive:

  • $100/month (BCSA, PCTEA, Exempt, Local 264)

  • $250/month for waiver/$100 for pool (BTF)

  • Paid annually in January (not retroactive)

  • Only one family policy is allowed if married to another Board of Education employee

  • The non-enrolled employee may take the waiver

  • Use your union's hire packet to complete the Waiver form HERE

Important

  • Submit forms completely and accurately

  • Missing information or documents will delay processing

RELATED FILES