Please review the Life Event Matrix before completing the required form.
When you enroll in the medical insurance, dental insurance, health flexible spending, or dependent care assistance program, you cannot make any changes to your benefit elections until the next open enrollment period unless you experience a qualified life event, and the benefit change you request is consistent with the event. Qualified events are defined by Section 125 of the Internal Revenue Code, based on individual circumstances and plan eligibility.
*You have 31 days from the date of the event to request a change to your benefits due to a qualifying life event within Workday.
- 60 days is allowed for the birth of a baby or adoption.
**Comprehensive Dental Plan – may not change from comprehensive dental to basic dental plan until the 3-year lock-in period has been satisfied.
Change In Marital Status
Dependent Status Change
Insurance Status Change
Employment Status Change
Leave of Absence
Retirement
Change in Dependent Care Provider
Change in Residence
Life Event Matrix
Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Change in Marital Status | ||||
Marriage or Declaration of Domestic Relationship
Effective 1st of the month on or after event date
Documentation required: copy of marriage license or Declaration of Relationship form | May enroll newly eligible spouse/partner and other newly eligible dependents
May cancel coverage if you become covered by your spouse/partner’s plans
| May enroll or increase contribution
May decrease contribution (cannot drop below the amount that’s been claimed)
May cancel contribution if you become covered by your spouse health FSA plan | May enroll in account
May increase contribution if marriage increases dependent care expenses
May decrease contribution if the family elects dependent care assistance under spouse plan or marriage decreases dependent care expenses | |
Divorce – Annulment – Legal Separation
Effective 1st of the month on or after event date
Documentation required: copy of divorce decree or certificate of annulment or legal separation | Must remove former spouse/partner and spouse/partner’s eligible dependents
Cannot remove other dependents from coverage unless they are added to former spouse/partner’s plan
May enroll in coverage/add dependents if the event causes loss of coverage under former spouse/partner’s plan | May decrease contribution to reflect loss of your spouse/partner’s eligibility (cannot drop below the amount that’s been claimed)
May enroll or increase contribution if coverage is lost under your spouse/partner’s health FSA plan | May enroll in account
May increase contributions if event increases dependent care expenses or causes loss of coverage under spouse/partner’s plan
May decrease contributions if event decreases dependent care expenses | |
Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Dependent Status Change | ||||
Spouse/Partner Death
Effective 1st of the month following event date
Documentation required: copy of death certificate or obituary | Remove spouse/partner from coverage
May enroll in coverage or add any dependent that loses coverage under deceased spouse/partner’s plan
| May decrease contribution (cannot drop below the amount that’s been claimed)
May enroll or increase contribution if coverage is lost under your spouse/partner’s health insurance or health FSA plan | May enroll in account
May increase contribution | |
Dependent Death
Effective 1st of the month following event date Documentation required: copy of death certificate or obituary | Remove dependent from coverage | May decrease contribution (cannot drop below the amount that’s been claimed) | May decrease contribution or cancel contribution if you have reduced dependent care expenses
| |
Birth or Adoption
Effective as of event date
Documentation required: copy of birth certificate or certificate of adoption | May add newly eligible dependent to existing plans
May cancel coverage if become covered by spouse/partner’s plan
May add spouse/partner and other eligible dependents if losing coverage under another plan | May enroll or increase contribution
May decrease contribution (cannot drop below the amount that’s been claimed) | May enroll in account
May increase contribution | |
Dependent Status Change – becomes a full-time student (> age 26 and unmarried)
Effective 1st of the month following event date Documentation required: verification of full-time student status (examples: copy of class schedule, letter from college or university) | May enroll newly eligible dependent to existing plans
| No change allowed | No change allowed | |
Dependent Status Change – no longer eligible (> age 26 and married or not a full-time student
Effective 1st of the month following event date
Documentation required: copy of marriage certificate | Remove dependent that is no longer eligible | May decrease contribution (cannot drop below the amount that’s been claimed) | No change allowed | |
Dependent Status Change – Judgment, Decree or Order (including QMCSO)
Effective as of event date
Documentation required: copy of judgment, decree or court order
| May add dependent to existing plan if required under order
May cancel dependent if other parent provides coverage under order | May enroll or increase contribution if adding dependent to coverage
May decrease contribution if dropping dependent from coverage (cannot drop below the amount that’s been claimed) | May enroll, increase or decrease contribution | |
| Dependent age 26 | Allowed to remain on coverage through December 31st of the year dependent turns 26 | No changes | No changes | |
| Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Insurance Status Change | ||||
Employee, Spouse/Partner or Dependent loses eligibility for coverage
Effective 1st of the month on or after event date
Documentation required: letter from employer or insurance company verfiying member names and date the coverage will end
| May enroll in coverage
May add eligible family members if they lost coverage under another plan
| May enroll in account
May increase contribution | May enroll in account or increase contribution
May decrease or cancel contribution | |
Employee, Spouse/Partner or Dependent gains eligibility for coverage
Effective 1st of the month on or after event date
Documentation required: letter from employer or insurance company verfiying member names and the effective date of new coverage
| May cancel coverage for yourself and/or eligible dependents if become covered by another plan | May decrease contribution (cannot drop below the amount that’s been claimed) | May enroll in account or increase contribution
May decrease or cancel contribution
| |
| Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Employment Status Change | ||||
Employee no longer benefits eligible - less than 20 hours per week
| Coverage terminates at the end of the month in which eligibility changes
May continue coverage through COBRA for up to 18 months, if not eligible for Medicare | Contribution terminates at the end of the month in which eligibility changes
May continue to submit claims but only for expenses incurred while you were an eligible employee
May continue participation on an after-tax basis through COBRA for the remainder of the year
| Contributions terminate at the end of the month in which eligibility changes
May continue to submit claims but only for expenses incurred while you were an eligible employee or while you were employed elsewhere or looking for employment
| |
Employee becomes benefits eligible – 20 to 40 hours per week
| May enroll in coverage – effective as of event date | May enroll in account – effective as of event date | May enroll in account – effective as of event date | |
| Rehired less than 30 days after termination of employment | ISU will reinstate prior plan elections
Coverage begins as of hire date | ISU will reinstate prior contribution
Coverage begins as of hire date | ISU will reinstate prior contribution
Coverage begins as of hire date | |
| Termination/Separation of Employment | Coverage terminates at the end of the month in which you separate
May continue coverage through COBRA for up to 18 months, if not eligible for Medicare | Contribution terminates at the end of the month in which you separate
May continue to submit claims but only for expenses incurred while you were an eligible employee
May continue participation on an after-tax basis through COBRA for the remainder of the year | Contributions terminate at the end of the month in which you separate
May continue to submit claims but only for expenses incurred while you were an eligible employee or while you were employed elsewhere or looking form employment
| |
| Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Leave of Absence | ||||
| Begin unpaid leave in excess of one continuous calendar month (No FMLA) | May elect to continue coverage – employee billed for total cost of premiums
May cancel coverage | May continue contributions
May cancel contributions
| May continue contributions
May cancel contributions | |
Begin unpaid FMLA leave in excess of one continuous calendar month
| May cancel coverage
May continue coverage – billing for any premiums due at the same cost share as active employees
| May continue contributions
May cancel contributions | May continue contributions
May cancel contributions | |
| Return from unpaid leave or unpaid FMLA in excess of one continuous calendar month | May re-enroll prior elections | May re-enroll prior contribution | May re-enroll prior contribution | |
| Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Retirement | ||||
| Employee’s Retirement | Current coverage terminates at end of the month in which you retire
May be eligible for retiree medical and dental coverage
| Contributions terminate
May continue to submit claims but only for expenses incurred while you were an eligible employee
May continue participation on an after-tax basis through COBRA for the remainder of the year
| Contributions terminate
May continue to submit claims but only for expenses incurred while you were an eligible employee | |
| Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Change in Dependent Care Provider | ||||
Change in childcare provider rates or number of hours worked by provider Effective 1st of the month following event dateDocumentation Required: Flex Spending Account Salary Reduction Agreement | No change allowed | No change allowed | May increase or decrease contribution that corresponds to the new costs
| |
| Life Event | Medical/Rx & Dental Plans | Health Flexible Spending Account | Dependent Care Assistance Program | |
| Change in Residence | ||||
Relocate out of state of Iowa
Effective 1st of the month on or after event date Update home address in Workday | May change from HMO to PPO medical plan
No change to dental or vision plans | No change allowed | May increase or decrease contribution if child care provider changes | |
Spouse and/or dependent child(ren) arrival to U.S.
Effective as of event date Documentation required: copy of passports with dates of arrival | May add newly eligible dependents to existing plans | May increase contribution if already enrolled in FSA | May enroll in account | |
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