Life Changes Happen — Your Benefits Should Keep Up
Life can change quickly. You might get married, welcome a new child, or relocate to a new city. These milestones, known as Qualifying Life Events (QLEs), impact more than just your personal life — they can also affect your health insurance plan.
Typically, benefit election changes are only allowed during the annual open enrollment period. However, a qualifying life event may make you eligible for a special enrollment period, allowing you to adjust your benefits when life demands it.
Let’s explore how QLEs work, what events qualify, and how APS makes it easier to update benefits without the hassle of paperwork.
What Is a Qualifying Life Event?
A Qualifying Life Event is a significant change in your personal circumstances that may permit you to enroll in, drop, or modify your health insurance or other benefits outside of open enrollment. Common events include:
- Marriage or divorce
- Birth or adoption of a child
- Death of a dependent (you may need a death certificate)
- Relocating to a new area that impacts your coverage
- Losing eligibility for Medicare
- Gaining eligibility for Medicaid or CHIP (Children’s Health Insurance Program)
- Spousal abandonment or domestic abuse
- Change in employment status (e.g., part-time to full-time)
- Dependent aging out of children’s health insurance
- Loss of coverage from a parent’s or spouse’s plan
- A court order requiring benefits updates (such as adoption records or birth certificates)
Why QLE Flexibility Matters
Changes don’t always happen on a schedule. Your job can shift unexpectedly, or your family may experience a relocation. You shouldn’t have to wait months to update your benefits when these things happen.
With the QLE feature in APS, you can:
- Keep your benefits aligned with real-time changes
- Avoid gaps in coverage
- Protect your household from unexpected costs
- Adjust to new circumstances, like dependents or job changes
For HR teams, QLE flexibility means less time spent on manual corrections and more time for strategic initiatives.
Special Enrollment Periods: What You Should Know
When you experience a QLE, you may also be qualified for a special enrollment period. This special window lets you make benefit changes outside of the annual open enrollment period.
Important facts to remember:
- You generally have 60 days to take action.
- You may have to wait until open enrollment if you miss this window.
- Missing it could mean lapses in coverage or higher out-of-pocket costs.
Examples of events that may qualify you include:
- Having or adopting a child
- Marriage or divorce
- Moving to a new coverage area
- Losing health coverage from a parent or spouse
- Losing eligibility for Medicare
- A legal court order requiring changes
If one has happened recently, now is the time to explore your options.
Medicaid, CHIP, and Coverage for Children
If your financial situation changes due to a life event, you might become eligible for public health coverage programs like Medicaid or CHIP.
CHIP stands for the Children’s Health Insurance Program. It offers coverage to children whose families earn too much for Medicaid but still need affordable insurance. If your child qualifies, it’s important to act quickly to avoid gaps in care.
You may also gain eligibility for Medicare or Medicaid due to a job loss or income change, both of which are considered qualifying life events. Supporting documentation may include:
- Birth certificates
- Adoption records
- A death certificate
- Proof of spousal abandonment or domestic abuse
What You Can Change After a QLE
Once your QLE is approved, you can:
- Add or remove dependents
- Choose a new health insurance plan
- Cancel coverage if no longer needed
- Enroll in Medicaid or CHIP if eligible
These options help ensure your benefits remain relevant to your current circumstances, whether you’re adjusting to a new baby or handling a major legal or family event.
How Flexible Tools for Updating QLEs and Electing Benefits Can Help
For HR teams:
- Reduced administrative burden
- Fewer missed enrollment deadlines
- Smoother audits and reporting
For employees:
- Benefits that evolve with life changes
- Clearer, more empowering experiences
- Faster, self-guided updates through the APS platform
When changes are simple and timely, everyone wins.
Don’t Miss the Deadline
You typically have just 60 days from the date of your qualifying life event to make any necessary changes. If you miss that, you might be stuck waiting until the next open enrollment period.
Avoid unexpected costs or gaps in coverage by taking action early. APS can make the process seamless.
How APS Simplifies the Process
The QLE workflow in APS is intuitive and fully digital. Here’s how it works:
- A life event occurs, such as a birth, relocation, or job change.
- The employee logs into the APS dashboard.
- They select the event type, input the date, and upload documentation (like a death certificate, birth certificate, or adoption records if needed).
- The employee selects new benefits or adjusts existing ones.
- The HR admin reviews and approves the request.
Everything happens in one secure, centralized platform — eliminating confusion, delays, and paperwork.
Want to Learn More?
APS makes managing Qualifying Life Events easy, efficient, and compliant. Ready to improve your benefits experience? Explore our Benefits Administration solution.
