Special Enrollment: Qualifying Events

Outside of open enrollment periods, you may also be able to enroll yourself or dependents in the University Health Plan or make changes if a qualifying event happens in your life. This is known as a special enrollment period.

Enrollment and changes requested within a special enrollment period must be completed within 31 days of the qualifying event and may require supporting documentation. If do you not enroll or complete changes within 31 days of the qualifying event, you will need to wait until the next open enrollment period.

Qualifying Events: Enrollment

Marriage

A new eligible dependent acquired through marriage must be enrolled within 31 days of the marriage date. Coverage will be effective as of the date of marriage.

Required Documentation: Enrollment form. Additional documentation of the marriage date, such as a marriage certificate, may also be required.

Birth

An enrollment form must be submitted within 31 days of the child's date of birth and arrangements must be made to pay any applicable premium, which will be calculated from the child's date of birth.

Please note: Aetna may automatically send you temporary identification cards that list a newborn dependent upon the child’s birth. This will reflect 31 days of mandated newborn coverage but does indicate coverage beyond that time. If you want to add the child to your plan, you must still complete a formal enrollment application within 31 days of birth.

Required Documentation: Enrollment form. Additional documentation of birth date may also be required.

Adoption or Placement for Adoption

New dependent(s) who are eligible for coverage due to adoption or placement for adoption must be enrolled within 31 days of that event. Coverage will be effective as of the date of adoption or placement for adoption.

Required Documentation: Enrollment form. Additional documentation of adoption date may also be required. 

Qualified Medical Child Support Orders

Eligible participants and dependent(s) may be enrolled in accordance with the terms of an order for medical child support.

Required Documentation: Enrollment form. Additional documentation of the court order may also be required.

Loss of Other Coverage

If you or a dependent were covered under another group health plan (including COBRA continuation) or had other medical insurance when you declined UHP coverage, you may become eligible for enrollment if you have lost or will lose coverage due to:

  • Death of a spouse
  • Divorce
  • Legal separation
  • Termination of employment
  • Reduction in the number of hours of employment
  • Cessation of the employer's contributions
  • Exhaustion of COBRA continuation coverage

Eligible participants and dependents must be enrolled within 31 days from the loss of other coverage. UHP coverage will be effective as of the date coverage was lost.

Required Documentation: Enrollment form. Additional documentation of divorce, death of spouse or legal separation date or HIPAA certificate/letter from the former plan may also be required.

Qualifying Events: Termination

If you or a dependent enrolls in another group or individual plan as the result of a significant change, including starting a new job, changes in employment status or change in enrollment status at an academic institution, you may request a termination of UHP coverage prior to the expiration of the current benefit period.

Required Documentation: Written request to terminate coverage must be submitted to the plan administrator within 31 days of the change in status. Additional documentation such as HIPAA certificate/letter from an insurance carrier or employer that confirms your name and the effective date of new coverage may also be required.

If the request is accepted by the plan administrator, coverage will terminate on the effective date of the new coverage.