A qualifying life event (QLE) is a significant change in an employees life that can make them eligible for a Special Enrollment Period. This allows them to enroll in health plans outside the yearly open enrollment period.
The following situations are considered qualifying life events:
Marriage
Birth of a child
Adoption of a child
Legal separation/divorce
Death in the family
Employee turns 26 (and loses prior coverage under parent's/guardian's plan)
Move to a new location (not always applicable depending on the new location, as most of our plans are national)
Involuntary loss of previous coverage
Employees have 30 days after a qualifying life event to submit proof of the QLE to our enrollment team (484-416-0769 or support@vitablehealth.com).
In most instances, we will backdate any new coverage to the first of the month. For example, if an employee has a baby on May 15th and wants to add their child to their plans, their coverage under Vitable would be effective as of May 1st.
If an employee gets married or e a domestic partnership, their new coverage will start on the 1st of the following month. For example, if they make it official on May 15th and want to add their partner to their plans, their MEC, MVP, or ICHRA coverage would be effective as of June 1st.
Qualifying Life Event | Desired Change | Documentation Required to make change |
Birth of Child | Enroll in or change coverage for myself and/or any new dependents | A birth certificate, a hospital record of birth, or a certificate of live birth |
Adoption of Child | Enroll in or change coverage for myself and/or any new dependents | Adoption or guardian papers |
Marriage | Enroll in coverage for myself, my spouse, and/or any new dependents | Marriage certificate |
Marriage | Drop coverage for myself and/or any dependents | Proof of coverage from new insurance carrier |
Divorce | Enroll in coverage for myself and/or any new dependents | Divorce decree and letter of cancellation from previous carrier |
Divorce | Drop spouse from coverage | Divorce decree |
Divorce | Drop spouse and dependents from coverage | Divorce decree and proof of coverage from new insurance carrier |
Domestic Partnership | Enroll in or change coverage for myself, my partner, and/or any new dependents | Domestic partnership state certificate or Vitable's affidavit and 3 of the following documents: common ownership of real property, common ownership of a motor vehicle, driver's license listing a common address, proof of joint bank accounts or credit accounts, proof of designation as the primary beneficiary for life insurance or retirement benefits, or assignment of a durable property power of attorney or health care power of attorney |
Domestic Partnership | Drop coverage for myself and/or any dependents | Domestic partnership certificate and proof of coverage from new insurance carrier |
End of Domestic Partnership | Enroll in or change coverage for myself, my partner, and/or any dependents | Declaration of termination of domestic partnership and letter of cancellation from previous carrier |
End of Domestic Partnership | Drop partner from coverage | Declaration of termination of domestic partnership |
End of Domestic Partnership | Drop partner and/or any dependents from coverage | Declaration of termination of domestic partnership and proof of coverage from new insurance carrier |
I or my dependent obtained alternate coverage | Drop coverage for myself and/or any dependents | Proof of coverage from new insurance carrier |
I or my dependent lost insurance coverage | Add coverage for myself and/or any dependents | Letter of cancellation from previous carrier |
Change in dependent care cost or coverage | No change available | Documentation from the dependent care provider confirming the change |