All regular, full-time employees who experience a Qualified Life Event (QLE) during the benefits plan year may make changes to their current health plans and/or FSA enrollment.
The list below will show which events may constitute a QLE and the time frames within which you must submit changes to your coverage.
Life Events can be submitted by going to the Life Events section under the Myself tab in WEC Life and then clicking on the I have a Qualifying Life Event link. Life Events cannot be future dated. Once a Life Event is approved it will be effective on the date the life event occurred.
New Child
An employee may change their benefit elections within 31 days of the birth of a newborn or adoption.
The effective date will be the date of birth or when the adoption is finalized
Newborns will automatically be covered for the first 31 days after birth or adoption.
Health coverage will end if the newborn or adopted child is not added to the employee’s medical plan.
Claims submitted within the first 31 days will still be paid even if newborn is not added to employee’s coverage.
Supporting documentation must be in within a reasonable amount of time after the newborn is added to the employee’s coverage.
A copy of the Government-Issued Birth Certificate or Adoption Certificate must be turned in.
A Life Event for a newborn can be submitted before supporting documentation and SSN is received.
Employees without current coverage can pick up coverage within the initial 31 days after birth.
The effective date in these cases will be the date of birth.
Marriage or Divorce
An employee may change their benefit elections within 31 days of being married or divorced.
The effective date will be the date of marriage or the date the divorce is finalized.
The effective date will be the date listed on the marriage license.
Coverage will end on a former spouse at the end of the month the divorce is finalized.
Supporting documentation must be sent in before the life event can be approved.
A copy of the Government-Issued Marriage Certificate must be sent in for marriage and a court finalized divorce decree must be sent in for a divorce.
Employees without current coverage can pick up coverage within the initial 31 days after the marriage.
The effective date in these cases will be the 1st day of the following month.
Loss or Gain of Coverage Elsewhere
An employee may change their benefit elections within 31 days of gaining or losing coverage elsewhere.
Coverage can also be changed if a dependent gains or loses coverage elsewhere.
When losing coverage elsewhere, the effective date will be the day after the previous coverage has ended.
When gaining coverage elsewhere, the last day of coverage will be the day before the new coverage starts.
Supporting documentation must be sent in before the life event can be approved.
A document showing the employee or dependent’s name and the effective or last day of coverage must be sent in.
If an employee loses coverage through a Government Issued program, such as Medicaid or CHIP, then the time they have to enroll in coverage is 60 days.
Coverage will be effective the day after the Government Issued coverage ends.
Child Turns 26
An employee may change their benefit elections within 31 days of a covered dependent child turning 26.
The effective date of the changes will be the first day of the month following the dependent child turning 26.
The dependent child will automatically be removed from the employee’s health and life insurance plans on the last day of the month the dependent child turns 26.
No documentation is needed for these life events if child is currently covered.
Court Order
An employee may change their benefit elections within 31 days of a court order requiring coverage of a dependent child.
The effective date of the changes will be the day the court order is received.
Children will automatically be covered for the first 31 days after a court order is effective.
The coverage will end if the child(ren) is not added to the employee’s health plans within 31 days.
Supporting documentation must be sent in before the life event can be approved.
A copy of a court order showing the name of the Child(ren), required coverage and the effective date must be sent in.
Death of a Dependent
An employee may change their benefit elections within 31 days of the covered dependent's death.
The effective date of the changes will be the day after the dependent's death.
Supporting documentation must be sent in before the life event can be approved.
A copy of the death certificate must be sent in.
WEC provides EAP services for the loss of a loved one and a bereavement policy that allows for time off if needed. Contact the HR Helpline at 432.571.8741 to get more details.
If you have questions about your QLE that is not answered here, please call the HR Helpline at 432.571.8741 or call Shane Lee, Benefits Analyst, at 806.677.5854