Health Plan Qualifying Events:
Throughout the course of a plan year, certain qualifying events may occur which allow employees to add, change or terminate health or dental plan elections. To make any changes, you must notify the Division Manager of Payroll within thirty (30) days of the qualifying event date for these changes to be effective. These qualifying events must result in you, your spouse, or your qualified dependent(s) gaining or losing eligibility for health insurance coverage. Proper documentation surrounding any of these events is required.
Note: If the Division Manager of Payroll is not notified within thirty (30) days of the qualifying event date, employees will need to wait to make any changes to health plan elections until the open enrollment period.
Examples of Qualifying Events:
- Change in legal marital status, including marriage, death of spouse, divorce, legal separation, or annulment.
- Change in number of dependents, including a change due to birth or adoption.
- Change in employment status of employee, spouse, or dependent including a beginning or termination of employment, beginning or termination of an unpaid leave of absence, or a change in employment status (e.g. exempt to non-exempt).
- If a dependent satisfies or ceases to satisfy the requirements for coverage due to reaching a certain age or student status.
- If employee, spouse, same sex spousal equivalent, or eligible dependent changes his or her place of residence, but only if such change affects the persons eligibility for coverage.
Please contact the Personnel Department directly for more information about qualifying events, as this list is not inclusive of all qualified change in status events.
Change Application Forms:
Once a qualifying event has been approved, you may download change forms for major medical, vision and/or dental from the attachments listed below. Completed application forms noting the change should be routed directly to Vickie Mason at the School Board Office.
Please download major medical, vision and dental forms needed in order to make changes here: