Major life events – such as birth or adoption of a child, marriage, or divorce – enable you to make changes to your health care plans and add or drop eligible dependents from coverage.
You must enroll on a timely basis. When you experience a life event, also known as a qualifying status change, you have 60 days from the date of the event or within 60 days from the date that eligibility under other coverage ended to make changes to your benefits. If eligible dependents are not added to your contract within 60 days of the event or within 60 days from the date that eligibility under other coverage ended, those dependents may not enroll until the next open enrollment period for an effective date of July 1.
Explore below to learn more about each life event and the benefit changes you may make. If your life event is not found here, please contact your university HR to inquire about your ability to make enrollment changes.
| Event | Employee Action | Enroll/Notify HR Within |
| New Employee/Newly Eligible Employee | Contact your Human Resources Office within 30 days to complete enrollment for benefits
through the self-service portal or by hard copy form. *PEBTF guidelines permit enrollment at any time. |
30 Days |
| Add Dependent (birth, adoption, or marriage) |
Contact your Human Resources Office within 60 days to add your new Dependent. A newborn child of an employee is automatically covered from the moment of birth to 31 days after the date of birth. To be covered as a dependent beyond the 31-day period, the newborn child must be added as a dependent through the university human resources office within 60 days from the date of birth. |
60 Days |
| Loss of Dependent (divorce, loss of eligibility, any other reason) | Contact your human resources office within 60 days to remove the dependent(s). | 60 Days |
| Spouse obtains coverage through his/her employer | Contact your Human Resources Office within 60 days to drop coverage or; If your spouse will remain on as secondary coverage, complete coordination of benefits with Highmark. |
60 Days |
| Turning age 65 (you or spouse) or otherwise becomes eligible for Medicare | Contact your Human Resources Office and the Social Security Administration about Medicare and other benefits. They may remain on active coverage. | 3 months prior to turning age 65 |
| Retirement | Contact your Human Resources Office to discuss your retirement and potential eligibility for benefits. | 6 months prior to retirement |
| If you become disabled | Contact your Human Resources Office to find out how your coverage will be affected. | Immediately |
| Death | Your Dependents should contact your Human Resources Office to discuss health insurance continuation provisions | Immediately |
Employees covered under the State System Health Plan
Faculty, Coaches, Nonrepresented, OPEIU, POA
Employees covered under the PEBTF Health Plan
AFSCME, SCUPA, SEIU, PDA
In some cases, failure to notify your human resources office within the required time will result in losing election rights to COBRA benefits, and/or loss of any premium refund due to retroactive changes to tier of coverage.
In situations where claims are incurred and paid on a dependent that was not removed from coverage in the appropriate time listed above, the employee will be liable for any claim payments made that cannot be recouped by the insurance vendor. State System policy requires that employees who receive an overpayment in employee benefits, whether through administrative error or oversight, refund the amount of the overpayment.