Qualifying Family Status Change/ Life Event

  • Outside of open enrollment, changes to health and dental insurance, and flexible spending can only be made within 30 days of a "qualifying status change" (QSC), sometimes referred to as a "qualifying life event". 

    If you experience a qualifying life event as outlined below, please login into Peoplesoft and start a Life Event. 

    The Saint Paul Schools’ group insurance plans are governed by IRS guidelines that permit enrollment changes during the plan year only under specific circumstances called status changes.

    Please be aware in most cases:

    1. If you are canceling medical coverage for dependents, you typically cannot make changes to the medical plan you currently have.
    2. If you are adding dependents, you typically are able to make changes to your medical plan.

    Qualifying status changes for benefits include:

    • Addition of a dependent through marriage, birth, adoption, or custody changes.   
    • Loss of a dependent through death, divorce, or becoming ineligible for plan coverage (dependents currently on COBRA are not eligible to be added to the SPPS group policy).
    • Substantial change in employment status for you, your spouse, or your dependent's job that would affect benefit eligibility or benefit coverage (i.e. full to part time or vice versa, termination, change jobs, leave of absence, etc.) (Dependents currently on COBRA are not eligible to be added to the SPPS group policy).
    • Qualified Medical Child Support Order is issued. A copy of the QMCSO (court document) will be required.
    • Relocation that affects your benefit elections (i.e. moving outside a medical plan's service area)
    • Annual open enrollment for your spouse or dependent occurs at a different time than the SPPS open enrollment and results in a significant change in cost or coverage options. 

    In addition to the above list, qualifying family status changes for dependent care flexible spending reimbursement include:

    • Change in daycare providers

    If you have questions about a situation in which you believe may be a "Qualifying Status Change",  call 651.767.8200 or 651.767.8266 or email benefits@spps.org

    The Process:

    Please note all status changes and requests must be submitted from the employees SPPS email account.  

    You have 30 days from the date of the event to submit a qualifying status change online. Using Employee Self Service you will submit your request and upload supporting documentation.  Status Changes received outside of the 30 days will not be accepted.

    1. Submit your qualifying status change online with documentation through Employee Self Service by starting a Life Event.
    2. You will receive an email through your SPPS Email account from Benefits confirming the approval of the Life Event. 
    3. You will be able to make your change to your benefits in the Life event. 
    4. Once the status change has been processed you will receive a completion email through your SPPS Email account notice.
    5. SPPS will deduct, from an employee’s wages the necessary premiums to effect the Qualifying Status Change.  If an employee is on unpaid leave, payment must be made prior to coverage taking effect.  Benefits will notify you via email if there is any amount due.
    6. Status Changes are sent electronically to the carrier on a weekly basis after the effective date. Please allow 7-10 business days for activation with carrier. 
    7. Medical and/or dental cards for employees covered under Medica are available through Medica Customer Service (855-857-2045) or you can log on to your Medica home page and print one yourself.
    8. Medical cards for employees covered under PEIP are available through Innovo (952.746.3101)

     

    Required Documentation:

    Employees are responsible for providing supporting documentation of the change. 

    Qualified Status Change will not be approved without proper documentation.

     Documentation Examples:

    • Birth - Copy of the crib card or birth certificate
    • Adoption - Copy of the final signed adoption papers
    • Marriage - Copy of marriage license and if adding any dependents birth certificate(s)
    • Divorce - Copy of the divorce decree (first page, any pages showing benefits agreement and last page with court signature and date).
    • Spouse loss of coverage - Document showing date of benefits loss and names of dependents (under age 26) that are affected.
    • Spouse gains coverage - Document showing date of benefits began and names of dependents (under age 26) that are affected.
    • Spouse Open Enrollment held an annual Open Enrollment at a different time than SPPS - Copy of the Open Enrollment Notice with dates

    Employee Responsibilities:

    It is the employees responsibility to review their Benefit Summary available through Employee Self Service.  Benefit Summaries show benefits as of the date, make sure to enter the appropriate date at the top if a change in benefits is future dated.

    If you increase any optional life insurance(s) or short term disability, it is the employees' responsibility to obtain and complete the Evidence of Insurability form(s).  Employees will not see the change or charges until the District receives notification from the insurance underwriters that you were approved.

     

     

Benefit Forms