Qualifying Life Events
A qualifying life event is a personal change in status (such as marriage or birth of a child) which may allow an employee to change their benefit elections outside of the annual open enrollment period.
Documentation is required and varies depending on the event. An employee may add and drop dependents due to a qualifying life event, but cannot change their current plan enrollment. Changes are permitted only during the month of the event and the following two months. If a change is requested outside of this time period, the employee must wait until the next open enrollment period. Changes are effective the month following the completed approved enrollment.
Examples of qualifying life events include:
| Event | Documentation Required (Photos are not accepted) |
| Divorce |
Copy of the divorce decree showing that the divorce is final
*Must be reported immediately - see below |
| Marriage (of policyholder or dependent) | Copy of a valid marriage license or certificate |
| Birth of child | Copy of child(ren)'s birth certificate |
| Adoption | Copy of adoption papers |
| Adding coverage for a dependent child | Copy of child's birth certificate |
| Adding coverage for any other child who resides with the policyholder | Copy of court-ordered guardianship papers |
| Open Enrollment under spouse's or dependent's employer's benefit plan | Copy of printed material showing open enrollment dates and the employer's name |
| Death of spouse or dependent | Copy of death certificate |
| Beginning or end of spouse's or dependent's employment | Letter from the spouse's employer stating hire or termination date, effective date insurance was added or lost, type of coverage lost and the dependents that are covered |
MAKING CHANGES
To initiate a life event, visit the Qualifying Life Event Knowledge Base article or contact Shared Services directly at 304-293-6006 or SharedServices@mail.wvu.edu.
OTHER CONSIDERATIONS
Updating Beneficiaries
With any change in life status it is important to periodically review the beneficiaries you have on file for your life insurance policies and retirement accounts. Please review the WVU Shared Services knowledgebase FAQ – Making Beneficiary Changes to learn how to make updates for both life insurance and retirement accounts.
Divorce and Other Events Changing Eligibility
Qualifying life events which end eligibility (such as divorce) must be reported immediately (within 30 days of of the date of the final divorce decree). The employee must remove ex-spouse and any stepchildren from all insurance policies that they were covered. Please be advised that PEIA may pursue claims reimbursement and/or pursue prosecution of policyholders who do not report qualifying life events ending eligibility in a timely manner. See the PEIA Divorce page for additional information.
EIA Spousal Coverage Information
PEIA is required by law to apply a monthly spousal surcharge if your spouse is eligible for employer-sponsored coverage through his/her employer, and has PEIA coverage. The spousal surcharge will be added to health insurance premiums each month. If your spouse is eligible for coverage as an employee of a PEIA-participating agency, has Medicare, Medicaid, TRICARE or is retired, the spousal coverage surcharge does not apply. See the PEIA Spousal Coverage Information page for additional information.
PEIA Tobacco-Free Discount
Policyholders are reminded that in order to receive the PEIA Tobacco Free Discount, members must be free of tobacco use for at least 6 months. Tobacco use includes cigarettes, e-cigarettes, vape pens, chewing tobacco, pipe tobacco, and snuff. You may review and update your tobacco status by visiting PEIA's Manage My Benefits.