Personnel Support » Benefits » Mid Year Changes

Mid Year Changes

How to make a Mid Year Change

You are only permitted to make changes to your medical, dental, and vision benefits outside of the Open Enrollment period if you or an eligible dependent experience a qualifying life event (QLE) as defined by the IRS. Change made must be consistent with the qualifying event. You must submit your benefit change request and upload required verification within 30 days of the qualifying event. If you miss this window, you won't be able to make changes until the next annual open enrollment period. All changes must be requested through the Selerix Benefit Portal, via MyPLAN.

Examples of qualifying life events include:
 

  • Your or your dependent's loss or gain of other health plan coverage for any reason. This includes gain or loss of insurance through a spouse or parent's employer, Medicare, Medi-Cal, and all other health plan coverage options.

    • Verification required: A document from the other employer or insurance carrier is required which states 1) the name(s) of who was/is covered, 2) the specific plans that are beginning/ending (ex: medical, dental, vision), and 3) the effective date the plans begin or terminate.

  • Marriage

    • Verification required: Marriage Certificate

  • Birth or adoption of a child

    • Verification required: Hospital Verification Letter, or Birth Certificate, or Court Order

  • Dependent loss of eligibility, such as divorce or legal separation

    • Verification required: Date Stamped Divorce or Separation Decree

  • Death of a dependent

    • Verification required: Death Certificate

  • Performance of a Qualified Medical Child Support Order

  • Change in residence affecting eligibility or access

    • Verification required: Document verifying new address and date of move

 

For ALL requested changes, if you are newly enrolling an eligible dependent, verification of dependent status is also required. 

If your change during the year is a result of the loss of eligibility or enrollment in Medicaid, Medicare or state health insurance programs, you must submit the request for change within 60 days.

Important Notes regarding Mid-Year Changes:

• Birth and marriage life events allow for a "Tag Along" rule, meaning you may also enroll additional eligible dependents due to these two QLEs.

• Mid-year enrollments or changes to flexible spending accounts and legal plans are never allowable.

• Mid-year enrollment to life insurance is allowable for new dependents due to birth or marriage only.

• Mid-year termination is allowed for any legal plan with 12+ months of enrollment, as well as any life insurance policy at any time.