Life Events
When you enroll in benefits, your elections remain in effect to the end of the calendar year and you cannot make any changes until the next Open Enrollment period, which is usually in October. However, if you experience a qualified family status change during the calendar year, you may be able to make a benefit change that corresponds with the status change.
Facing a change?If you need a benefits enrollment change form, you may also want to look into the Work/Life Resource Center and FASAP services the university offers you. Work/Life can provide information about child care (referrals for child care and emergency needs), elder care and flexible scheduling. FASAP offers free-of-charge professional guidance to help
you face difficult situations at work or in your personal
life. |
Important Deadline
To change your coverage(s) when a qualified family status change occurs, you must act within 30 days of the qualifying event for the expected change to be accepted by the university. Otherwise, you will have to wait for the next Open Enrollment period in which you are eligible to participate and have the change(s) become effective the following January 1. In order to make an eligible change, contact the HR/Payroll Service Center within 30 days by calling 734-615-2000 locally, 5-2000 from the Ann Arbor campus, or 866-647-7657 toll free for off-campus long-distance calling. You may be asked to provide documentation of the change. It is especially important to delete any ineligible dependents from your coverage within the 30-day timeframe to avoid overpaying premiums that would not be refunded. For more information on how changes to your coverage affect your benefit costs, see Paying for Your Benefits.
Changing Your Coverage
You may change your coverage if you experience a qualified family status change and the benefit change you request corresponds with a gain or loss of eligibility for coverage. For example, a marriage is a family status change that would allow you to change from one-person medical coverage to two-person medical coverage because acquiring a new dependent is consistent with a gain in eligibility for medical coverage. See the links above for information specific to particular life events, such as birth, adoption, or divorce.
Qualified Family Status Changes
Qualified family status changes are defined
by Section 125 of the Internal Revenue Code, based on individual
circumstances and plan eligibility. This list of events
may not apply to every benefit plan.
To change your benefits coverage when a qualified family status change occurs, you must act within 30 days of the qualifying event.
- Legal marital status. Marriage, death of spouse, divorce, legal separation or annulment.
- Number of dependents. Birth, adoption, placement for adoption or death of a dependent.
- Employment status. Termination or commencement of employment by the employee, spouse, or dependent.
- Work schedule. Switch between part-time and full-time work, a strike or lockout, commencement of or return from an unpaid leave of absence, or an increase or decrease in hours of employment by the employee, spouse or dependent.
- Dependent status. Either satisfying or ceasing to satisfy the age or other requirements to qualify as a covered dependent under the plan.
- Resident or work site. Change in faculty or staff member's, spouse's, or dependent's residence or work site that result in loss of coverage.
- Domestic relations orders. A court order resulting from a divorce, legal separation, annulment, or change in legal custody that require medical coverage for the employee's child under the employee's medical plan, or can end contributions for the child if the order requests the employee's former spouse to provide the coverage.
- Medicare and Medicaid. A corresponding change is permitted due to the faculty or staff member's, spouse's, or dependent's gain or loss of Medicare or Medicaid eligibility.
Your Spouse's or Other Qualified Adult's Open Enrollment
Faculty and staff who have the opportunity to enroll on their spouse’s or OQA’s medical insurance plan may remove their dependent(s) or cancel their U-M medical insurance coverage at any time during the year. Eligible employees who cancel medical coverage may receive opt-out credit dollars for the remainder of the calendar year upon showing coverage through another non-U-M employer-sponsored plan. Canceling the U-M medical plan also cancels prescription drug coverage. In order to drop dependents or cancel your U-M coverage, faculty and staff must notify the HRRIS Benefits Transaction Team within 30 days after the new coverage takes effect by completing and submitting a Benefits Enrollment/Change Form (PDF).
Effective Date of Coverage Changes
If you submit a change form requesting an eligible benefit change to the HRRIS Benefit Transaction Team within 30 days of the status event, coverage changes are effective as of the event date. If you don’t report the change in your coverage(s) within 30 days of the change in status event, you must wait until the next Open Enrollment Period to make a change to your coverage(s). Any changes in your deduction amount due to a change in benefits enrollments resulting from a status change will be deducted from your paycheck. Deductions are retroactive to the event date if the event date is the first of the month. If the event date is after the first of the month, deductions begin on the first full pay period after the event date. To minimize the impact of retroactive deductions, it is recommended that you report your benefit changes as soon as possible.
Moving out of a Managed Care Service Area
If you are covered by a managed care medical plan and move outside the service area for more than 60 days, you must change your medical insurance coverage mid-year by completing the Moving out of a Managed Care Service Area form (PDF) and sending the form to the HRRIS Benefits Transaction Team within 30 days after the date you move. Your new coverage will become effective the first day of the month following the date your form is received, or the first of the month after the day of your move, whichever is later.
Moving out of a Managed Care Service Area Form (PDF)
Special Enrollment Under HIPAA
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a special enrollment period for medical insurance may be available if you lose medical coverage under certain conditions or when you acquire new dependents by marriage, birth, or adoption.
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment by completing the Group Health Insurance Application for Special Enrollment form (PDF) and sending the form to the HRRIS Benefits Transaction Team within 30 days after your other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
Questions about Mid-Year Changes?
Questions about mid-year changes affecting your University of Michigan benefits should be directed to the HR/Payroll Service Center at 734-615-2000 locally, 5-2000 from the Ann Arbor campus, or 866-647-7657 toll free (for off-campus long-distance calling). Or you may email your questions to benefits.office@umich.edu.
Benefits Enrollment/Change Form (PDF)
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.