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Qualified Life Events

  Life Events Matrix (12/17/2015)

When you enroll in health insurance, dental insurance, life insurance and/or the flexible spending accounts, your benefit elections remain in effect to the end of the calendar year and you cannot make any changes until the next enrollment and change period.

You cannot make any changes until the next enrollment and change period unless you experience a qualified life event and the benefit change you request is consistent with the event. For example, a marriage is a family status change that would allow you to change from single health coverage to family health coverage because acquiring a spouse is consistent with a gain in eligibility for health coverage.

Qualified events are defined by Section 125 of the Internal Revenue Code, based on individual circumstances and plan eligibility. The following list may not apply to every benefit plan.

Qualified Life Event Categories

You may be able to change your benefit elections if…

  • You have a change in your legal marital status.
  • You have a change in the number of your dependents.
  • You have a change in your employment status.
  • Your spouse or dependent has a change in their employment status.
  • Your dependent has a change in his or her eligibility status.
  • You, your spouse or dependent has a change in residence.
  • You, your spouse or your dependent becomes entitled to Medicare or Medicaid.
  • You are served with a judgment, order or decree.
  • There is a change in cost by your dependent care provider.

This list may not apply to every benefit plan. For specific information, review the life events matrix.

Opportunities to Enroll in Coverage During the Year

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a special enrollment period for health insurance is available in the following circumstances. You may enroll in the health plan within 30 days of any of the following events:

  • Adoption or placement for adoption
  • Birth
  • Loss of other coverage
  • Marriage

Opportunities to Change Coverage During the Year

If you are already enrolled in a health plan, HIPAA allows you to add eligible family members to your already existing health plan AND enroll in a different health plan within 30 days of the following events:

  • Adoption or placement for adoption
  • Birth
  • Loss of other health coverage
  • Marriage
  • Divorce or legal separation
  • Death of spouse or dependent

Finally, if you are already enrolled in a health plan, the following life events allow you to enroll in a different health plan regardless of whether you are adding eligible family members.

  • Commencement of an unpaid leave-of-absence or FMLA leave in excess of 30 days.
  • Death of spouse or dependent
  • Decrease in work hours from full time (30 or more hours per week) to part time (20 – 29 hours per week.)
  • Return from an unpaid leave-of-absence or FMLA leave in excess of 30 days.

Changing Your Coverage

To change your coverage when a qualifying event occurs you must act within 30 days of the event (60 days in the case of birth or adoption) for the change to be accepted; otherwise, you will have to wait for the next enrollment and change period in which you are eligible to participate and have the change become effective the following January 1. You may be asked to provide documentation of the change.


The Benefits Management Team of the Iowa Department of Administrative Services developed this website to provide you with information about your benefit options, and serve as a valuable resource for information about your benefits.  The benefits described at this website are subject to change.  Nothing herein shall be construed as a guarantee of benefits.  This website is not a complete description of the State of Iowa’s benefit plans.  Nothing on this website supersedes or changes any of the terms and conditions of any plan documents, insurance policies, or other legal agreements.  If the wording in this website contradicts any plan documents, laws, regulations, administrative rules, insurance policies, or other legal agreements, the wording in the official documents and agreements will govern.

If you have any questions, please contact your Human Resources Associate or Personnel Assistant.