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Special Open Enrollment

UNDERSTAND

A “special open enrollment” opportunity is created when a qualifying life event occurs in your life or the life of one of your dependents that allows you to make insurance and other changes outside of annual open enrollment. These life events include marriage, birth of a new child, gain or loss of other coverage and many other life events as stipulated by the Internal Revenue Code (IRC). The changes requested must correspond to the nature of the event that creates the special open enrollment period.

Depending on the nature of the qualified life event, you may be allowed to:

Unless otherwise noted below, you must submit the appropriate form(s) to UW Benefits no later than 60 days after the event that created the special open enrollment opportunity. You may also be required to provide proof of eligibility documentation of dependent status, and/or proof of the qualified event.

Special Open Enrollment Conditions

List of Qualified Events

Any one of the events listed below may create a special open enrollment period, in which you are allowed to enroll or remove a dependent, waive your medical plan enrollment, enroll yourself after previously waiving medical plan enrollment, or change your health plan election.

When you get married, you are allowed to take any of these actions:

  • Add your new spouse and any dependent children of your spouse to your health plan(s).*
  • Remove dependent(s) from your medical and/or dental plan provided that the dependent(s) enroll under your new spouse's plan.
  • Change medical and/or dental plan(s) provided that you enroll your new spouse.
  • Enroll yourself after previously waived medical coverage provided that you enroll your new spouse or children acquired through marriage.*
  • Waive your own medical coverage provided that you enroll under your new spouse's plan.

*Existing uncovered dependents cannot be enrolled.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates of coverage changes depend on which of the following action(s) you choose:

Add dependent(s): Effective either the first day of the month following the month of marriage or the first day of the month after the month during which the enrollment form is received by UW Benefits, whichever is later.

Remove dependent(s): Effective either the last day of the month of marriage or the last day of the month during which the enrollment form is received by UW Benefits, whichever is later.

Change medical and/or dental plan: Effective either the first day of the month following the month of marriage or the first day of the month after the month during which the enrollment form is received by UW Benefits, whichever is later.

Enroll after waiving medical coverage: Effective either the first day of the month following the month of marriage or the first day of the month after the month during which the enrollment form is received by UW Benefits, whichever is later.

Waive medical coverage: Effective either the last day of the month of marriage or the last day of the month during which the enrollment form is received by UW Benefits, whichever is later.

Additional changes you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account (FSA) or change your existing FSA deduction
  • Enroll in the Dependent Care Assistance Program (DCAP) or change your existing DCAP deduction
  • Enroll your new spouse in the optional life insurance subject to the employee coverage requirements

Note: FSA and DCAP forms should be sent to the third-party administrator noted on the enrollment forms.

Additional changes you may wish to consider:

  • Start a Health Savings Account (HSA) deduction provided that you changed to a Consumer-Directed Health Plan (CDHP).
    Important Note: Tax law does not allow HSA and FSA participation in the same tax year.
  • Update your life insurance beneficiary.
  • Update your retirement plan beneficiary.
  • Update your UW emergency contacts.

When you register a new domestic partnership, you are allowed to take any of these actions:

  • Add your partner and partner’s children to your health plan(s).*
  • Remove dependent(s) from your plan(s) provided that the dependent(s) enroll under your partner's plan.
  • Change medical and/or dental plan provided that you enroll your new domestic partner.
  • Enroll yourself after previously waived medical coverage in order to enroll your domestic partner or children.*
  • Waive your own medical coverage if you enroll under your new domestic partner's plan.

*Existing uncovered dependents cannot be enrolled.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add dependent(s): Effective either the first day of the month following the month of partnership registration or the first day of the month after the month during which the enrollment form is received by UW Benefits, whichever is later.
  • Remove dependent(s): Effective either the last day of the month of partnership registration or the last day of the month during which the enrollment form is received by UW Benefits, whichever is later.
  • Change medical and/or dental plan: Effective either the first day of the month following the month of partnership registration or the first day of the month after the month during which the enrollment form is received by UW Benefits, whichever is later.
  • Enroll after waiving medical coverage: Effective either the first day of the month following the month of partnership registration or the first day of the month after the month during which the enrollment form is received by UW Benefits, whichever is later.
  • Waive medical coverage: Effective either the last day of the month of partnership registration or the last day of the month during which the enrollment form is received by UW Benefits, whichever is later.

Additional change you are allowed to make at this time:

  • Enroll your partner and/or dependent children in the optional life insurance subject to the employee coverage requirements

Additional changes you may wish to consider:

  • Start a Health Savings Account (HSA) deduction if you change to a Consumer-Directed Health Plan (CDHP).
    Important Notes:Federal regulations do not allow the use of HSA funds for health care expenses of partners or the children of partners. Also, tax law does not allow HSA and FSA participation in the same tax year.
  • Update your life insurance beneficiary
  • Update your retirement plan beneficiary
  • Update your UW emergency contacts

When you have a new child, adopt a child, or assume a legal obligation for total or partial support of a child in anticipation of adoption, you are allowed to take these actions:

  • Add the child to your health plans(Existing uncovered dependents cannot be enrolled.)
  • Add your spouse or registered domestic partner to your health plan(s).
  • Change medical and/or dental plan provided that you enroll the child.
  • Enroll yourself after previously waived medical coverage provided that you enroll the child.
  • Waive your own medical coverage provided that you enroll under your spouse or domestic partner's coverage.

Submit these forms to UW Benefits within 60 days of the event. (Exception: Requests to cover the child only are accepted up to one year after birth):

Effective dates depend on which of the following action(s) you choose:

  • Add child(ren): Effective the day of birth or adoption or the day you assume legal obligation.
  • Add spouse or domestic partner: Effective the first day of the month of your child’s birth, adoption, or assumption of legal responsibility.
  • Change medical and/or dental plan: Effective the first day of the month of birth, adoption or assumption of legal responsibility.
    Note: Individuals participating in a Consumer-Directed Health Plan with a Health Savings Account (CDHP/HSA) may be required to wait one additional month if the enrollment form is received after the 23rd of the month.
  • Enroll after waiving medical coverage: Effective the first day of the month of birth, adoption, or assumption of legal responsibility.
  • Waive medical coverage: Effective the last day of the month of birth, adoption, or assumption of legal responsibility or the last day of the month during which the enrollment form was received by the Benefits Office, whichever is later.

Additional changes you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account (FSA) or change your existing FSA deduction
  • Enroll in the Dependent Care Assistance Program (DCAP) or change your existing DCAP deduction
  • Enroll your new child in the optional life insurance subject to the employee coverage requirements

Note: FSA and DCAP forms should be sent to the third-party administrator noted on the enrollment forms.

Additional changes you may wish to consider:

  • Start an HSA deduction if you change to a CDHP/HSA plan
    Important Note: Tax law does not allow HSA and FSA participation in the same tax year.
  • Update your life insurance beneficiary
  • Update your retirement plan beneficiary

When your child becomes eligible as an extended dependent through assumption of legal custody or legal guardianship, you may be allowed to take any of these actions:

  • Add your new dependent to your health plans.*
  • Change medical and/or dental plan provided that you enroll your new dependent.
  • Enroll yourself after previously waiving medical coverage provided that you enroll your new dependent.*

*Existing uncovered dependents may not enroll.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add eligible dependent(s): Effective the first day of the month following the month during which PEBB certifies new extended dependent.
  • Change medical and/or dental plan: Effective the first day of the month following the month during which the extended dependent is certified.
  • Enroll after waiving medical coverage: Effective the first day of the month following the month in which the extended dependent is certified.

Additional changes you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account or change your existing FSA deduction
  • Enroll in the Dependent Care Assistance Program or change your existing DCAP deduction

Note: FSA and DCAP forms should be sent to the third-party administrator noted on the enrollment forms.

Additional changes you may wish to consider:

  • Start an HSA deduction if you change to a CDHP/HSA plan
    Important Note: Tax law does not allow HAS and FSA participation in the same tax year.
  • Update your life insurance beneficiary
  • Update your retirement plan beneficiary

When your dependent is a disabled dependent over age 26, you are allowed to take any of these actions:

  • Add your dependent to health coverage.
  • Change medical and/or dental plan provided that you enroll your dependent.
  • Enroll yourself after previously waiving medical coverage in order to enroll your dependent.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add eligible dependent(s): Effective the first day of the month following the month during which the PEBB certifies the dependent for coverage.
  • Change medical and/or dental plan: Effective the first day of the month following the month during which the dependent is certified by the PEBB.
  • Enroll after waiving medical coverage: Effective the first day of the month following the month during which PEBB certifies the dependent as disabled.

Additional changes you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account (FSA) or change your existing FSA deduction
  • Enroll in the Dependent Care Assistance Program (DCAP) or change your existing DCAP deduction

Note: FSA and DCAP forms should be sent to the third-party administrator noted on the enrollment forms.

Additional changes you may wish to consider:

  • Start an HSA deduction if you change to a Consumer-Directed Health Plan (CDHP).
    Important Note: Tax law does not allow HSA and FSA participation in the same tax year.
  • Update your life insurance beneficiary
  • Update your retirement plan beneficiary

When you or your dependent loses other health insurance coverage, you are allowed to take any of these actions:

  • Add the dependent to your health plans. (Existing uncovered dependents cannot be enrolled.)
  • Add your spouse or registered domestic partner to your health plan(s)
  • Change medical and/or dental plan if you enroll the dependent
  • Enroll yourself after previously waived medical coverage

Submit these forms to UW Benefits within 60 days of the event:

Effective dates of coverage changes depend on which of the following action(s) you choose:

  • Add eligible dependent(s): Effective either the first day of the month following the date of loss of coverage or the date on which the form is received in UW Benefits, whichever is later.
  • Change medical and/or dental plan: Effective either the first day of the month following the date of loss of coverage or the date on which the enrollment form is received by UW Benefits, whichever is later.
    Note: Individuals participating in a Consumer-Directed Health Plan with a Health Savings Account (CDHP/HSA) may be required to wait one additional month if the enrollment form is received after the 23rd of the month.
  • Enroll after waiving medical coverage: Effective either the first day of the month following the date of loss of coverage or the date on which the form is received in UW Benefits, whichever is later.

Additional change you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account (FSA) or change your existing FSA deduction

Note: FSA forms should be sent to the third-party administrator noted on the enrollment forms.

If you or your dependent gains eligibility for other comprehensive group medical coverage, you are allowed to take any of these actions:

  • Waive your coverage if you gain other coverage.
  • Waive your dependent(s) coverage if your dependent(s) gained other coverage.
However, note the following:
  • If you waive your coverage, you must also waive coverage for your dependent(s).
  • Dental coverage cannot be waived.
  • The University of Washington pays your entire dental premium.

Submit these forms to UW Benefits within 60 days of the event:

Effective date for waiving medical coverage is the last day of the month during which the dependent gained other coverage or the last day of the month during which the enrollment form was received by the Benefits Office, whichever is later.

Additional changes you are allowed to make at this time:

  • Enroll in or change medical Flexible Spending Account (FSA) as long as you are not currently enrolled in a Consumer-Directed Health Plan (CDHP).
  • Enroll in or change Dependent Care Assistance Program (DCAP).

Note: FSA and DCAP forms should be sent to the third-party administrator noted on the enrollment forms.

When you or your dependent has a change in enrollment under another employer plan during its annual open enrollment that does not align with the PEBB's annual open enrollment, you are allowed to take any of these actions:

  • Add dependent who ended coverage during an open enrollment under another employer plan.*
  • Remove dependent(s) who are enrolled under open enrollment at another employer.*
  • Enroll yourself after returning from waived enrollment status provided that you enroll a dependent who has disenrolled under open enrollment at another employer.
  • Waive your medical coverage provided that you gained other comprehensive group coverage under open enrollment at another employer.

*Note: Existing uncovered dependents who did not change coverage under the other open enrollment may not change PEBB coverage.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add eligible dependent(s): Effective either the first day of the month following the coverage change under the other plan’s open enrollment or the first of the month following the month during which the form is received by UW Benefits, whichever is later.
  • Remove dependent(s): Effective either the first day of the month following the coverage change under the other plan’s open enrollment or the first of the month following the month during which the form is received by UW Benefits, whichever is later.
  • Enroll after waiving medical coverage: Effective either the first day of the month following the coverage-waiver date under the other plan’s open enrollment or the first of the month following the month during which the form is received by UW Benefits, whichever is later.
  • Waive medical coverage: Effective the last day of the month during which coverage is added under the other plan’s open enrollment or the or the last day of the month during which the enrollment form was received by the Benefits Office, whichever is later.

Additional change you are allowed to make at this time:

  • Enroll in or change Dependent Care Assistance Program (DCAP) if eligible dependent is enrolled or removed from coverage

Note: DCAP forms should be sent to the third-party administrator noted on the enrollment forms.

When your dependent(s) move from outside the United States to live within the United States, you are allowed to take any of these actions:

  • Add newly arrived dependents to coverage. (Uncovered dependents already living in the U.S. may not be enrolled.)
  • Enroll yourself after previously waived medical coverage if you enroll your arriving dependent(s).

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add dependent(s): Effective either the first day of the month following the dependent’s arrival date to the United States or the date on which the form is received in UW Benefits, whichever is later.
  • Enroll after waiving medical coverage: Effective either the first day of the month following the dependent’s arrival date to the United States or the date on which the form is received in UW Benefits, whichever is later.

When you or your dependent has a change in residence that affects health plan availability, you are allowed to change medical and/or dental plan(s).

Submit this form to UW Benefits within 60 days of changing residence:

The effective date for changing medical and/or dental plan(s) is either the first day of the month following the date of the residence change or the date on which the enrollment form is received by UW Benefits, whichever is later.

Note: Individuals participating in a Consumer-Directed Health Plan with a Health Savings Account (CDHP/HSA) may be required to wait one additional month if the enrollment form is received after the 23rd of the month.

When a court order or National Medical Support Notice (NMSN) requires you or any other individual to provide insurance coverage for your eligible dependent, you are allowed to take any of these actions:

  • Add a dependent child to coverage as ordered by the Court. (Other existing uncovered dependents cannot be enrolled.)
  • Remove from your UW coverage a dependent who has received other court-ordered coverage.
  • Change medical and/or dental plan provided that you enroll a child under court order.
  • Enroll yourself after previously waived medical coverage provided that you enroll a child under court order.
  • Waive your medical coverage provided that your covered dependent(s) receive other court-ordered coverage.

Note: The UW may be required to add coverage for you and/or your dependent(s) under the NMSN.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add dependent(s): Effective either the first day of the month following the date specified in the court order or the date on which the form is received in UW Benefits, whichever is later.
  • Remove dependent(s): Effective either the last day of the month following the date of court order or the date on which the form is received in UW Benefits, whichever is later.
  • Change medical and/or dental plan: Effective either the first day of the month following the court-ordered coverage date or the date on which the enrollment form is received by UW Benefits, whichever is later.
  • Enroll after waiving medical coverage: Effective either the first day of the month following court-ordered effective date or the date on which the form is received in UW Benefits, whichever is later.
  • Waive medical coverage: Effective either the first day of the month following the effective date of other court-ordered coverage or the first of the month during which the enrollment form is received by UW Benefits, whichever is later.

Additional change you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account (FSA) or change your existing FSA deduction.

Note: FSA forms should be sent to the third-party administrator noted on the enrollment forms.

When you or your dependent becomes eligible or loses eligibility for premium assistance through Medicaid or a state Children's Health Insurance Program (CHIP), you are allowed to take any of these actions:

  • Add dependent who lost eligibility for coverage under Medicaid or CHIP*
  • Remove dependent who becomes eligible for and enrolls in coverage under either CHIP or Medicaid.
  • Change medical and/or dental plan(s) provided that you remove your dependent from coverage or enroll your dependent to coverage.
  • If you previously waived coverage, you may enroll yourself for coverage in order to cover a dependent who has lost coverage under either Medicaid or CHIP or to cover yourself if you lost coverage under either Medicaid or CHIP.*
  • Waive your medical coverage provided that you enroll in Medicaid when you become eligible for that coverage.

*Existing uncovered dependents who did not lose eligibility may not enroll.

Submit these forms to UW Benefits within 60 days of the event:

Effective dates depend on which of the following action(s) you choose:

  • Add dependent(s): Effective either the first day of the month following the last day of state premium assistance or the date on which the form is received in UW Benefits, whichever is later.
  • Remove dependent(s): Effective either the last day of the month following the state premium assistance eligibility date or the date on which the form is received in UW Benefits.**
  • Change medical and/or dental plan: Effective either the first day of the month following the date eligible for state premium assistance or the date on which the form is received in UW Benefits.
  • Enroll after waiving medical coverage: Effective either the first day of the month following the last day of state premium assistance or the date on which the form is received in UW Benefits, whichever is later.
  • Waive medical coverage: Effective either the last day of the month following the date eligible for state premium assistance or the date on which the form is received in UW Benefits.**

**Note: CDHP/HSA participants may be required to wait one additional month if the enrollment form is received after the 23rd of the month.)

Additional change you are allowed to make at this time:

  • Enroll in a medical Flexible Spending Account (FSA) or change your existing FSA deduction.

Note: FSA forms should be sent to the third-party administrator noted on the enrollment forms.

When you or your dependent becomes entitled to Medicare or are enrolling in or disenrolling from a Medicare Part D plan, you are allowed to change medical and/or dental plan(s).

Make sure you submit this form to UW Benefits within 60 days of the event:

If your current health plan becomes unavailable due to your or your dependent's entitlement to Medicare, you must select a new health plan as described in WAC 182-08-196.

The effective date to change medical and/or dental plan is the first day of the month or the latter of the:

  • Date you are entitled to Medicare,
  • Date of enrollment in a Medicare Part D plan,
  • Date of disenrollment from a Medicare Part D plan,
  • Date on which the form is received in UW Benefits; or
  • If you are enrolled in a Consumer-Directed Health Plan with a Health Savings Account (CDHP/HSA), the most recent (HSA) contribution month as verified by HealthEquity.

Additional change you can make at this time:

  • Enroll in or change medical Flexible Spending Account (FSA) provided that you are not currently enrolled in a CDHP-HSA plan. Contact the FSA plan administrator for details.

When you or your dependent's current health plan becomes unavailable because you or your dependent is no longer eligible for a health savings account (HSA), you are allowed to change your medical plan.

Submit these forms to UW Benefits within 60 days of the event:

Effective date to change medical is the first day of the month following either the date the health plan becomes unavailable or the date on which the enrollment form is received by UW Benefits, whichever is later.

When you or your dependent experience a disruption of care that could function as a reduction in benefits for you or your dependent for a specific condition or ongoing course of treatment (requiring PEBB approval), you are allowed to change medical and/or dental plan(s).

Submit these forms to UW Benefits within 60 days of the event:

Effective date to change medical and/or dental plans is the first day of the month following either the date of the care disruption or the date on which the enrollment form is received by UW Benefits, whichever is later.

EXPLORE

Disclaimer: The Qualifying Life Event(s) shown above highlights benefit options arising from a change in family status. It does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority.

Changing Enrollment