Qualifying Life Events Documentation Guidelines

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Qualifying Life Event   Desired Change     Eligible changes for FSA/DCFSA     Documentation Required to make change

Birth of Child
  Enroll in or change coverage for myself and/or any new dependents     Enroll in or increase FSA/DCFSA    

A birth certificate, a hospital record of birth, or a certificate of live birth that you’ll need to change your health insurance plans. All of these can be acquired from the hospital where your child was born.

Adoption of Child

  Enroll in or change coverage for myself and/or any new dependents     Enroll in or increase FSA/DCFSA    

Welcoming a new addition to the family? Have your adoption or guardian papers that establish your parental rights of the child ready to change your coverage.

Marriage   Enroll in coverage for myself, my spouse, and/or any new dependents     Enroll in or increase FSA/DCFSA deferrals    

Congratulations newlyweds! You’ll need your marriage certificate from the city clerk’s office to make a change. Remember, this is not your marriage license and can only be obtained after you say, “I do.”

Marriage   Drop coverage for myself and/or any dependents     Decrease DCFSA*    

Switching to your spouse’s insurance?

In addition to your marriage certificate, you’ll need proof of coverage from your new insurance carrier with the start date of your coverage. If you’re dropping dependents from your current plan, you’ll need this letter for each one that is being dropped.

Divorce  

+Enroll in coverage for myself

-Or-

+Add dependents to coverage

    Enroll in or increase FSA/DCFSA deferrals    

To make these insurance changes you’ll need a divorce decree obtained from the city clerk’s office, as well as a letter of cancellation from your previous carrier with the last date of coverage. Each person that is affected should have their own letter of cancellation.

Divorce   Drop spouse from coverage     Decrease FSA/DCFSA*    

If you would like to drop your spouse from your coverage, submit a divorce decree obtained from the city clerk’s office.

Divorce   Drop spouse and dependents from coverage     Decrease FSA/DCFSA*    

In addition to a divorce decree from the city clerk’s office, you’ll need to provide proof of coverage for each dependent you’re dropping. This letter from their new carrier should include the start date of their plan.

Domestic partnership   Enroll in or change coverage for myself, my partner, and/or any new dependents     Enroll in or increase FSA/DCFSA    

Congratulations! If you have a domestic partnership state certificate, then that’s all you need to make a change to your insurance.


If you don’t have this certificate, you’ll need to fill out Justwork’s domestic partnership affidavit and submit three of the following documents:

  • Common ownership of real property (joint deed or mortgage agreement) or a common leasehold interest in property
  • Common ownership of a motor vehicle
  • Driver's license listing a common address
  • Proof of joint bank accounts or credit accounts
  • Proof of designation as the primary beneficiary for life insurance or retirement benefits or primary beneficiary designation under a partner's will
  • Assignment of a durable property power of attorney or health care power of attorney
Domestic partnership   Drop coverage for myself and/or any dependents     Decrease DCFSA*    

Changing coverage to your partner’s? You’ll need a domestic partnership certificate, as well as proof of coverage with your plan’s start date from your new insurance carrier. A separate letter must be provided for each dependent that is dropping coverage from your current plan.

If you do not have a domestic partnership certificate, you’ll need to provide 3 of the documents listed above, Justwork’s domestic partnership affidavit, and proof of coverage.

End of Domestic Partnership   Enroll in or change coverage for myself, my partner, and/or any dependents     Enroll in or increase FSA/DCFSA     To make changes to your coverage for this reason, you’ll need to obtain a declaration of termination of domestic partnership, which can be obtained from the city clerk’s office. You’ll also need a letter of cancellation from the previous carrier with the last date of coverage. A separate letter must be provided for each person who will be affected by this change.
End of Domestic Partnership   Drop partner from coverage     Decrease FSA/DCFSA*     If you would like to drop your partner from your plan, submit a declaration of termination of domestic partnership.
End of Domestic Partnership   Drop partner and/or any dependents from coverage     Decrease FSA/DCFSA*     If you’d like to drop your partner or any dependents from your coverage, you’ll need to obtain a declaration of termination of domestic partnership. For any dependents that are being dropped, provide a letter of proof of coverage from their new insurance carrier with the start date of their plan. A separate letter must be provided for each dependent who will be affected by this change.
I or my dependent obtained alternate coverage   Drop coverage for myself and/or any dependents     Decrease FSA/DCFSA*     Leaving a plan? All you need is proof of coverage from the new insurance carrier with the start date of coverage. Each person who is being dropped should have separate proof of coverage.
I or my dependent lost insurance coverage   Add coverage for myself and/or any dependents     Enroll in or increase FSA/DCFSA     Need a plan? Provide a letter of cancellation from the previous carrier with the last date of coverage for each person that needs coverage.
Change in dependent care cost or coverage   No change available     Enroll, increase, or decrease DCFSA     Documentation from the dependent care provider confirming the change is required.

 

*if you experience an applicable qualifying life event and would like to decrease or stop your FSA or DCFSA contributions, you will not be able to lower your election below the amount you have already contributed or used in your account.