Qualifying Life Events – Justworks Help Center

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What is a qualifying life event?

A qualifying life event, or a QLE, is designated as a change in your living situation that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly open enrollment period. Most QLEs also permit employees to enroll in or increase their FSAs.

What is considered a qualifying life event?

A qualifying life event can be one of the following:

Marriage / domestic partnership
Birth of a child
Adoption of a child
Legal separation / divorce
Death in the family
Employee turns 26 (and loses prior coverage under parent’s/guardian’s plan)
Move to a new location (not always applicable depending on the new location, as most of our plans are national)
Involuntary loss of previous coverage

How long do I have to submit a QLE?

When you have a qualifying life event, you can make updates to your benefits coverage by submitting proof of the QLE within 30 days of the event.

Otherwise, all changes must happen during your company’s open enrollment period.

In most instances, coverage will begin on the first of the following month. For example, if you had a baby on May 15th and wanted to add your child to your plans, their coverage under Justworks would be effective as of June 1st.

If you’re getting married or entering a domestic partnership, your new coverage will start on the 1st of the following month. For example, if you made it official on May 15th and wanted to add your partner to your plans, their coverage under Justworks would be effective as of June 1st.

If I do have a QLE, how do I update my plans with Justworks?

Master Policy Medical, Dental, & Vision Plans QLEs

The steps to submit your Master Policy Medical, Dental, and Vision Plans QLE are as follows:

If you’d like to update your plans with Justworks, navigate to the Benefits tab in your account. You’ll see the option to ‘Request a change.’

The next screen will have information about common Qualifying Life Events and the documentation that we’ll need from you to process any changes. Generally speaking, the documentation we’ll need for each QLE and requested change is as follows:

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 or change 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 who 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.

The next screen will have information about Qualifying Life Events and the documentation we’ll need from you to process any changes.

Note: Remember, any QLE has to be processed within 30 days of its occurrence!

From there, you’ll be able to select which type of event you’ve experienced and notify us of the plans you wish to change. We’ll also let you know how long we’ll have to process your changes, so it’s important that you get the proper documentation to us as soon as possible.

Once you submit your change request and attach the relevant documents, you’ll see a confirmation page reviewing your request. You should be on the lookout for the next steps from us shortly!

If you’re unsure if your event qualifies, please reach out to us at support@justworks.com.

Can I make changes to my plans outside of the QLE open enrollment window?

You are not able to make any changes to an elected insurance plan after the effective date of the plan or outside of your QLE open enrollment window. The IRS pre-tax rules govern when changes can be made to health insurance plans. Except in the event of a QLE, the pre-tax rules prohibit changes to an elected insurance plan after the effective date (i.e., elections must be irrevocable for the plan year or the remainder of the current plan year in the case of a newly eligible employee).

Open Market Medical Plan QLE Instructions

Note: If your enrollment is separated between Open Market Medical Plans and Master Policy Dental and Vision plans, you will have to submit updates for each plan separately.

To submit your Open Market Medical update, you’ll do so in your Justworks Benefits Center. To submit your Master Policy Dental and Vision updates, follow the steps outlined in the previous section.

The steps to submit your Open Market Medical Plan QLE are as follows:

Navigate to You > Benefits on the left side panel.

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Click the “Request change” button in the top right of the Qualified Life Event box.

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Select the type of QLE and the date the QLE event occurred. i.e., the birth of a baby on 2/4/2024: 2/4/2024 should be entered, not the date when coverage would be effective.

Select an action for each type of coverage. If you are not actioning on a certain type of coverage, select “No action”.

Click “Add dependent” to enter your dependent’s information.

Complete all the Dependent information fields.

Click “Add dependent”.

Click “Select Plan” on the plan you’re adding your dependent to.

Click “Continue”.

On the “Confirm your Selection” page, you can review and edit any of your selections. When ready, click “Submit” on the right to submit your QLE for review by your plan administrator.

What Happens Next?

- An email confirming this submission will be sent to the email associated with your Justworks account.
- Your company’s benefits administrator is responsible for approving your Open Market Medical Plan-specific QLE. Look out for communication from them, as additional documentation may be required.

Disclaimer

This material has been prepared for informational purposes only and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.