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Human Resources

Qualified Events

What is a Qualified Event?31

Each year during Open Enrollment (typically held each October/November) you have the opportunity to make new benefit elections or change your current elections for the coming calendar year.  After Open Enrollment has ended, you can’t make changes to the benefits elections unless you have a “Qualified Event”.  A Qualified Event is a life change event that either changes the number of your eligible family members or that causes you or a family member to gain or lose other coverage (either at Bowdoin or outside of Bowdoin).  The change that you are allowed to make because of a Qualified Event must match the event.  For example:

  • The birth, adoption or placement for adoption of a child would allow you to “add” your newly acquired dependent to your benefit plans.
  • If you get divorced or terminate your domestic partnership, you must drop coverage for your ex-spouse or ex-partner
  • When your child turns age 26 you must drop them from your coverage because they are no longer eligible.
  • If your spouse or domestic partner becomes eligible for benefits in a new job you could drop your coverage here at Bowdoin and move to his/her new plan.
  • If your spouse or domestic partner loses their job or moves to a part-time job and this causes him/her to lose their current benefits then you could elect coverage through Bowdoin.
  • If you or a family member stops being eligible for Medicaid, MaineCare or another state Children’s Health Insurance Program then you can elect coverage through Bowdoin.  If you or a family member becomes newly eligible for one of these programs, you could drop your coverage through Bowdoin. 

IMPORTANT!!!  It is your responsibility to notify Human Resources within 31 days if you have a qualified event.  Failure to do so may result in higher benefit premium payments for the remainder of the calendar year.  Failure to disclose a qualified event within 60 days will result in a forfeiture of COBRA rights.

What benefit plans can I change due to a Qualified Event?

Benefit plans that can be changed due to a Qualified Event are the health and dental plans.  Some status changes also allow you to change or elect a Medical and/or Dependent Care Flexible Spending Account.

When can I add or remove dependents from my benefit plan due to a Qualified Event?

You have 31 days from the date of the qualified event to complete a new benefits enrollment form making the change.  The change that you make is effective the 1st of the month following the date you return the completed enrollment form to Human Resources as long as it’s within the 31 day window allowed for you to enroll.  In the case of the birth or adoption of a child (or placement for adoption) the effective date is the child’s date of birth or adoption date as long as you make the election within 31 days.  You have 60 days after the date you become eligible for (or lose eligibility for) Medicaid, MaineCare or another state Children’s Health Insurance Program to drop or elect coverage through Bowdoin.

What do I do when I have a qualifying event?

Contact Human Resources as soon as possible to complete a new enrollment form.   We will answer any questions you have and help you make the changes you need.  Below are some examples of changes that are allowed and when they become effective:

Qualifying Event…

Then….

Change takes effect…

I’m getting married – how do I add my spouse to my plan?

You have 31 days from the date of your marriage to add your spouse to your plan.

This rule now also applies to same-sex couples who become married in the State of Maine or another state recognizing same-sex marriage.

The first day of the month following the date you return the completed enrollment form to Human Resources (must be within the 31 day enrollment window).

I’m getting divorced or my domestic partnership is ending – what should I do?

If your spouse or domestic partner is on your plan then you need to remove him/her within 31 days.

If you were on your spouse’s or domestic partner’s plan and now wish to join Bowdoin’s plan, you may do so within 31 days of the change.

If your domestic partnership is ending you will also need to complete a “Termination of Domestic Partnership” form and will now be eligible to enroll a new domestic partner for at least 12 months.

Coverage for your spouse or domestic partner must end as of the 1st of the month following the divorce or end of partnership.

My spouse or domestic partner lost their job and benefits and now we both need to join the Bowdoin plan.

You have 31 days from the date you lose other coverage to elect coverage through Bowdoin.

The first day of the month following the date you return the completed enrollment form to Human Resources (must be within the 31 day enrollment window).

My spouse or domestic partner got a new job and became benefits eligible and I want to join his/her plan instead.

You have 31 days from the date your spouse or partner becomes eligible for benefits in his/her new job to drop your coverage through Bowdoin.

The first day of the month following the date you return the completed enrollment form to Human Resources (must be within the 31 day enrollment window).

I’m having a baby or adopting a child.

You must add the child to the plan within 31 days of the birth or adoption (or placement for adoption).

The date of the birth, adoption or placement for adoption.

My child is turning age 26.

You will have 31 days from your child’s birthday to drop coverage.

Coverage must end the last day of the child’s birth month.

It’s Open Enrollment at my spouse or domestic partner’s employer and we want to join that plan instead.

You will have 31 days to drop coverage through Bowdoin.

The first day of the month following the date you return the completed enrollment form to Human Resources (must be within the 31 day enrollment window).

What Qualified Events apply to Medical and/or Dependent Care Reimbursement Accounts?

Some status or life change events also allow you to make changes (or make a new election) to a Medical and/or Dependent Care Reimbursement Account (also called Flexible Spending Accounts or FSA’s).  Some examples include:

  • The birth or adoption of a child allows you to increase or elect a new Medical Reimbursement Account.  You must make the change within 31 days of the birth/adoption and the increase or new election will be effective on the date your child was born or adopted.
  • If your child starts at a new daycare center or provider, you can begin or increase (if the cost of the new provider increases) your Dependent Care Reimbursement Account.  You must make the change within 31 days of the beginning of the new daycare and the change is effective the 1st of the month following the date you return the completed enrollment form to Human Resources.
  • If your child’s daycare ends or the hours are reduced, you can end or decrease your Dependent Care Reimbursement Account.  You must make the change within 31 days of the end of the daycare and the change is effective the 1st of the month following the date you return the completed enrollment form to Human Resources.

For detailed information please see the Summary Plan Document.