Human Resources

Qualifying Event - Benefit Changes

The Internal Revenue Service defines the events that allow you to make changes to your pretax benefit elections (medical, dental, flexible spending accounts) outside of Annual Open Enrollment. You can make benefit changes during the year only if you have a qualified change in family status (qualifying event). Changes must be consistent with the qualifying event.

To make changes, you must complete and submit a Qualifying Event - Benefits Change Form. With the form, you must also submit documentation of the event. The form and documentation must be submitted within 30 days of the event date (60 days for loss/gain of Mass Health Insurance). Coverage changes will be made effective (often retroactively) to the date of the event. As a result, there may be additional payroll deductions/credits for the retroactive changes.

Listed below are qualifying events and the documents that you are required to submit for each event:

  • Marriage (copy of marriage certificate)
  • Divorce / Legal Separation (copy of divorce agreement or legal separation)
  • Birth or Adoption of Child (birth: a copy of the birth certificate or hospital document provided in lieu of birth; adoption: a copy of legal adoption agreement)
  • Death of your spouse or dependent child (copy of death certificate)
  • Gain or loss of coverage through another source (letter or form from employer documenting loss or gain of coverage; must include name(s) of individuals impacted including dependents; type of coverage gained or lost; and the effective date of start/end of coverage)
  • Gain or loss of eligibility of coverage for MassHealth or CHIP (letter from MassHealth or CHIP agency)

For information and direction on other changes, you may wish to make at the time of a particular event, click on the event above.


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