TSS - Life Events- as of June 3, 2019

Life Events- as of June 3, 2019

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First Published  :Tue May 21 17:07:23 GMT 2019
Last Modified  :Mon Nov 04 14:33:09 GMT 2019
Last Published  :Mon Nov 04 14:33:09 GMT 2019
Summary : 

Response

Primary Information

    You may make a change to your benefits election if you have a qualified life event change in status (as described below) and the election change is on account of and consistent with the change in status. To change your elections, you must provide any proof of the change as may be required by the University and complete the Life Event Process (including making the elections) in eServe Employee Self Service Portal within 31 days of the change in status but not before the Event occurs; otherwise, you will be required to wait until the next annual open enrollment, usually early November of each year ncluding modifications within the Tufts Tiered Health Plans) or until you have another Life Event, whichever occurs sooner. 

    Eligibility:
     
    All active, regular employees at the University are eligible, provided that you are one of the following:
     
    • an exempt or non-exempt employee regularly scheduled to work 17.5 hours or more a week, with a minimum 90 days employment period; or
    • a faculty member with at least a half time (as determined by the academic department), two semester appointment
    • or a party to a job share contract (see summary plan description).  
    Beginning June 3, 2019, to begin the process of making a change, you will need to sign into the eServe Employee Self Service Portal and click on the Benefit Information tile to begin the life event.  Directions for making a change are available by reading the Life Events Job Aid .  Please note that in most cases you will need to submit documentation via an email to TSS along with completing the online information and await approval before an enrollment event is opened.

    You may only have one Life Event open at a Time.

    The Effective Date for all is the date of the Event.


    The following events are considered changes in status for purposes of the Plan:
    Life Event TYPEAcceptable documentation
    I got married or entered a domestic partnershipMarriage Certificate or Statement of Domestic Partnership
    Proof of Other Coverage if terminating Tufts plan

     
    If Employee is also Changing their Name, they must wait for approval of documentation submitted for change in Marital Status before proceeding and
    a separate Name Change submission of documentation (Social Security Card, passport, or court-issued document) and approval must occur before it is updated to the database.
    I had a baby  Certificate or statement of birth record letter from the hospital

    Proof of Other Coverage if terminating Tufts plan)

     
    I adopted or gained legal custody or guardianship of a childCompleted Adoption/Custody paperwork)
     
    I got divorced or legally separated 
    Court Document or Statement of Termination of Domestic Partnership
    If Employee is also Changing their Name, they must wait for approval of documentation submitted for change in Marital Status before proceeding and
    a separate Name Change submission of documentation (Social Security Card, passport, or court-issued document) and approval must occur before it is updated to the database.
    I or my dependent lost employer sponsored coverageDocumentation would include information on the employer’s letterhead detailing the coverage (Medical, Dental, Vision, etc.), which was gained or lost,   the reason for the change, the affected members, and the date of the change; this can include dependent’s Open Enrollment documentation
    I or my dependent moved out of my health plan’s service areaChange of Address must be done in eServe Employee Self Service Portal. Also, anything documenting the dependent's move such as Travel documents (passport stamp, flight receipts, etc.), updated address documents or ID (new state ID, new housing documents), effective date of acceptance to school, etc.
    I or my dependent began or returned from unpaid leaveEmployer documentation required
    I or my dependent had a change in job statusDocumentation would include information on the employer’s letterhead detailing the coverage (Medical, Dental, Vision, etc.), which was gained or lost,  the reason for the change, the affected members, and the date of the change)
    Coverage change for Medicare, Medicaid, MAHealthDocumentation is needed from Social Security or Department of Health; for a Retiree electing Medicare, the Medicare Election Form
    I or my dependent have reached age 26If the employee is turning age 26 and is covered under another plan, or if the employee has a dependent turning age 26 covered under another plan, and wants to enroll in the Tufts University benefits, he/she must provide supporting documentation from the parent’s employer as proof of the loss of coverage. Documentation from the plan provider is acceptable if it clearly indicates the individual is a dependent on the coverage and who the subscriber is
     (Note that if an employee has a dependent/child enrolled on the Tufts plan age out, this is not a Life Event and is handled outside of this system)

     
     

    Rules governing changes to Qualified Benefit Plans are regulated by Section 125 of the IRS Code regarding Cafeteria Plans, which are defined as plans that allow participants to choose between taxable and non-taxable benefits.  Tufts benefits plan is considered a Cafeteria Plan and must adhere to these regulations.
     
    Your election change must be on account of and consistent with the change in status. Examples of the consistency requirement include:
     
    • If a new health, dental, or vision benefit becomes available through the University (or an existing benefit is eliminated) during the plan year, or if a similar change occurs under a plan of your Spouse or dependent’s employer, you may elect the new coverage (or may elect another option if a coverage has been eliminated), and may make corresponding election changes regarding similar coverage for the balance of the plan year; however this does not apply to the Health Care Flexible Spending Account. 
    • If your share of the cost of Health, Dental, or Vision coverage, or daycare provider cost under the Dependent Care Flexible Spending Account, significantly (generally which means 25% or more) increases or coverage is significantly curtailed, you may change your current election and elect similar coverage offered by the University for the balance of the plan year. Cost increases imposed by a daycare provider who is your relative are not considered significant and your Dependent Care Flexible Spending Account election cannot be changed for the balance of the plan year on account of such expense. 
      If permitted under the applicable insurance contracts, you may be allowed to change health insurance providers during the plan year. Normally, such a change may take place only during the open enrollment period prior to each plan year. However, you may be permitted to change providers where there has been a significant (generally 25% or more) change in the cost or coverage level of you or your Spouse’s health coverage during the plan year, as determined by the University
      .
      Please note that an employee is able to change "plans" as well as coverage levels for a qualifying life event.  Under the IRS tag-along rule, if the event is adoption/birth, a spouse or Domestic Partner can also be added at the same time as the child. 

      Children of DP or Spouse are not able to be added to a plan unless there are court documents showing legal guardianship.

     
     

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Keywords

    Formerly known as Qualified Status Changes, QSC, Benefit Changes, Life, Events. Changes