Qualified Life Events

• Change in legal marital status
• Change in number of dependents or dependent eligibility status
• Change in employment status that affects eligibility for you, your spouse/domestic partner, or dependent child(ren)
• Change in residence that affects access to network providers
• Change in your health coverage or your spouse’s/domestic partner’s coverage due to your spouse’s/domestic partner’s employment
• Change in your or a dependent’s eligibility for Medicare or Medicaid
• Court order requiring coverage for your child
• “Special enroliment event” under the Health Insurance Portability and Accountability Act
  (HIPAA), including a new dependent by marriage, birth or adoption, or loss of coverage under another health insurance plan
• Event allowed under the Children’s Health Insurance Program (CHIP) Reauthorization Act (you have 60 days to request enrollment due to events allowed under CHIP).

You must submit any changes within 30 days of the event.