Human Resources & EO

Qualifying Events

Employees can enroll in health insurance "outside of Annual Enrollment" if they have a qualifying event (marriage, birth or adoption, loss of health coverage elsewhere, divorce or legal separation, remarriage, or death of a spouse).  The following events are considered "qualifying events" that allow you to add your dependent to your health insurance right away without waiting for annual enrollment.  See section below on adding Optional Life Insurance as most of these qualifying events also allow you to purchase Optional Life Insurance without evidence of medical insurability during the first 31 days after the event.  Check out the GiC Benefits and family Status Changes Questions & Answers

Birth/Adoption* - You should add your new dependent onto your insurance within 30 days of the birth.  Bring a letter from the hospital, or adoption paperwork to Human Resources and complete the necessary paperwork to add your dependent to your health insurance and dental insurance.  AFSCME union employees must notify the Massachusetts Public Employees Fund directly at 800.325.5214.

Marriage* - This is considered a "qualifying event" and you do not have to wait for annual enrollment to enroll your spouse in the Commonwealth's health plan. Enrollment beings on the first of any month "following the marriage".  Bring a copy of your marriage certificate to Human Resources within 30 days of your marriage.

Loss of Coverage Elsewhere - If the employee was not covered under a GIC health insurance Plan (but does carry the basic life insurance) and their spouse loses their job and benefits, the employee can enroll in the GIC health plan (family coverage) by showing proof of the spouse's "loss of coverage" and a copy of their marriage certificate and copies of birth certificates for their dependents they wish to cover.

Divorce or Legal Separation* - The Group Insurance Commission requires that you notify them in the event of a divorce or legal separation.  Bring a copy of the following pages of your legal separation agreement or divorce decree to Human Resources:    

• Page with absolute date
• Health insurance language
• Signature pages

Read the following website on Divorce and Remarriage

Remarriage* - If an employee or former spouse remarries, the GIC must be notified.  Health coverage for a former spouse ends.  Failure to report a divorce, legal separation or remarriage may result in financial consequences to the employee or former spouse.  For remarriage of an employee, please come to Human Resources:    

• Complete a change Form 1
• Bring copy of new marriage certificate
• Complete Data Form IDF
• Human Resources will forward to the GIC.

Read the following website on Divorce and Remarriage

Depending on the health insurance language in the separation agreement or divorce decree, the GIC will offer the former spouse COBRA coverage or a divorced souse rider.  The GIC will contact both the employee and former spouse directly.

Death of Spouse* - If you do not have dependents covered on your health insurance, and your spouse dies, go to Human Resources and switch from a family plan to an individual health plan.

*Family Status Change (OPTIONAL LIFE INSURANCE):
Effective Oct. 1, 2008, insured employees with Basic Life & Health Insurance or Basic Life Insurance only, who have a qualifying family status change which occurs on or after October 1, 2008, are eligible to either enroll for Optional Life Insurance coverage up to four times salary, without a medical, or increase their Optional Life Insurance amount up to four times salary without medical evidence.  The effective date of this new coverage will be determined by the GIC.  The following events qualify as a family status change:     

• Marriage of Employee
• Divorce of Employee
• Birth/Adoption of a Child
• Death of Spouse

Procedures - Within 31 days of the qualifying event, the employee can apply for or increase their Optional Life coverage up to four times without any medical evidence of insurability.  The GIC must receive the request within 31 days of the qualifying family status change.  Requests received after 31 days will require the employee to complete and pass medical evidence of insurability.  The employee must complete GIC's Change Form 1 and attach proof of the qualifying family status change.

Qualifying Event Documentation Required
Marriage Copy of the marriage certificate
Divorce The following sections of the divorce decree: 
     - section on health insurance
     - page with the absolute date
     - signature page
Birth or Adoption Copy of the certified birth certificate or copy of the adoption agency's placement letter with child's name and date of birth Death of a Spouse Copy of the death certificate