Status Change


Overview

A status change allows you to change coverage elections for the following benefits within 31 days of a qualifying event; normally you could only change these elections during initial hire or the annual open enrollment period:

  • Medical and prescription coverage
  • Dental coverage
  • Vision coverage
  • Flexible spending account (FSA)
  • Life insurance

A qualifying status change includes:

  • Marriage
  • Divorce
  • Domestic partnership
  • Death
  • Birth
  • Adoption
  • Certain family relations orders/decrees
  • Change from full-time to part-time employment or vice versa for you or your spouse/domestic partner
  • Commencement or return from an unpaid leave of absence for you or your spouse/domestic partner
  • Employment begins or ends, or open enrollment period for spouse/domestic partner

Required Documentation

The following form(s) and documentation must be submitted together to the OEB within 31 days of any qualifying status change.

1: Status change indication

2: Supporting documentation

› Marriage
› Divorce
  • A copy of the final divorce decree
› Domestic partnership
› Death
  • A copy of the death certificate or obituary
› Birth
  • A copy of the birth certificate (We understand that this takes time. Please add your newborn as a dependent within 31 days of date of birth and follow up with the birth certificate once received; same for the social security number.)
› Adoption
  • A copy of the adoption decree
› Loss of coverage
  • A HIPAA letter from the other carrier, or
  • A COBRA letter that shows coverage is being offered due to a loss of coverage elsewhere
› Certain family relations orders/decrees
  • Legal documents from a court order
› Change from full-time to part-time employment or vice versa for you or your spouse/domestic partner
  • If a State employee
    • A copy of the CS3
  • If not a State employee
    • A letter from the other employer's HR office proving a loss of coverage due to the employee no longer being eligible
› Commencement or return from an unpaid leave of absence for you or your spouse/domestic partner
  • If a State employee
    • A notification from HR stating that the employee is going on leave or returning from leave
  • If not a State employee
    • A letter from the other employer's HR office proving a loss of coverage due to a leave, or a gain of other coverage due to a return
› Employment begins or ends, or open enrollment period for spouse/domestic partner
  • A letter from the spouse's HR office indicating a start of employment, a termination of employment, or open enrollment