Qualifying Life
Event -
A qualifying life event (QLE) is
an event that allows you to
enroll, or if you are already enrolled, allows you to change your enrollment outside of an
Open Season.
The following chart lists the QLEs and the enrollment actions you may take.
Qualifying
Life Event
From Not
Enrolled to
Enrolled
Increase
Enrollment
Type
Decrease
Enrollment
Type
Cancel
Change
from One
Plan to
Another
Marriage
Yes
Yes
No
No
Yes
Acquiring
an eligible
family
member
(non-
spouse)
No
Yes
No
No
No
Losing a
covered
family
member
No
No
Yes
No
No
Losing
other
dental/
vision
coverage
(eligible or
covered
person)
Yes
Yes
No
No
No
Moving out
of regional
plan's
service area
No
No
No
No
Yes
Going on
active
military
duty, non-
paystatus
(enrollee or
spouse)
No
No
No
Yes
No
7
2018
Enroll at www.BENEFEDS.com
Qualifying
Life Event
From Not
Enrolled to
Enrolled
Increase
Enrollment
Type
Decrease
Enrollment
Type
Cancel
Change
from One
Plan to
Another
Returning
to pay
status from
active
military
duty
(enrollee or
spouse)
Yes
No
No
No
No
Returning
to pay
status from
Leave
without
pay
Yes (if first
time
enrollment
or cancelled
during
LWOP)
No
No
No
Yes (if
enrollment
cancelled
during
LWOP)
Annuity/
compensation
restored
Yes
Yes
Yes
No
No
Transferring
to an
eligible
position*
No
No
No
Yes
No
*Position must be in a Federal agency that provides dental and/or vision coverage with 50
percent or more employer-paid premium and you elect to enroll.
The timeframe for requesting a QLE change is from 31 days before to 60 days after the
event. There are two exceptions:
• There is no time limit for a change based on moving from a regional plan’s service
area; and
• You cannot request a new enrollment based on a QLE before the QLE occurs, except
for enrollment because of a loss of dental or vision insurance. You must make the
change no later than 60 days after the event.
Generally, enrollments and enrollment changes made based on a QLE are effective on the
first day of the pay period following the one in which BENEFEDS receives the enrollment
or change. BENEFEDS will send you confirmation of your new coverage effective date.
Once you enroll in a plan, your 60-day window for that type of plan ends, even if 60
calendar days have not yet elapsed. That means once you have enrolled in either plan,
you cannot change or cancel that particular enrollment until the next Open Season, unless
you experience a QLE that allows such a change or cancellation.
Cancelling an enrollment
You may cancel your enrollment only during the annual Open Season. An eligible family
member’s coverage also ends upon the effective date of the cancellation.
Your cancellation is effective at the end of the day before the date OPM sets as the Open
Season effective date.
Coverage ends when you:
• no longer meet the definition of an eligible employee or annuitant;
When Coverage Stops
8
2018
Enroll at www.BENEFEDS.com
