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Qualifying Life Events for ASRS Medical or Dental Insurance

What is a Qualifying Life Event?

A qualifying life event allows you the opportunity to enroll or to make changes to existing coverage for yourself or your dependents outside of the annual Open Enrollment Period. 

You must make these changes no later than 31 calendar days after the event, unless a different deadline is indicated for a specific qualifying life event as noted below. 

Following are the Qualifying Life Events recognized by the ASRS for enrollment and/or changes to your existing coverage outside of the annual Open Enrollment Period. ASRS has the sole discretion to determine whether a Qualifying Life Event has occurred and whether your situation allows you to enroll or to make changes to existing coverage.

Retirement

New retirees are free to enroll and add dependent coverage in any plan they are eligible for at the time of their retirement. Supporting documentation will not be required, unless you wish to cover a dependent child over the age of 26.

Your application must be submitted within 31 days of your retirement date. Coverage will be effective on the first day of the month after you retire and submit your enrollment application for coverage; however, premium deductions (retroactive to your coverage effective date) will not be deducted from your monthly pension payment until your retirement benefit has been finalized. Read more about retirement and health insurance premiums, as well as the premium benefit subsidy by visiting AzASRS.gov and selecting the "Retiree" tab.

Change in marital status

You may enroll in a plan, change plans, and/or add dependent coverage for new dependents resulting from a new marriage, including the spouse, even if you declined to enroll in a plan during the previous Open Enrollment Period.

If the change in marital status results in the loss of other coverage (for example due to divorce, legal separation, annulment, or the death of a spouse), you and your dependents may enroll in a plan or change plans. You may (and must in the case of a spouse) also remove a dependent due to a change in marital status such as divorce, legal separation, annulment, or death of a spouse. You may be asked to provide documentation that supports the occurrence of this qualifying event.

Your enrollment application must be submitted within 31 days of the date of your qualifying event. Coverage will be effective on the first day of the month after you submit your enrollment application.

Change in dependent status

You may enroll in a plan, change plans and/or add dependent coverage for new dependents resulting from a change in dependent status such as a birth or adoption, even if you declined to enroll in a plan during the previous Open Enrollment Period. In such cases, you may also add a dependent not previously covered. 

You may also remove dependent coverage in the event of a change in dependent status. You may be asked to provide documentation that supports the occurrence of this qualifying event. 

Your enrollment application must be submitted within 31 days of the date of your qualifying event. Coverage will be effective on the first day of the month after you submit your enrollment application for coverage.

Change in primary residence

You may enroll in a plan, change plans, and/or add or remove dependents if you have a change in your place of residence affecting coverage availability. Your address on file with the ASRS must correspond to the coverage area in which you are enrolling (Arizona or nationwide).

Your enrollment application must be submitted within 31 days of the date of your qualifying event. Coverage will be effective on the first day of the month after you submit your enrollment application for coverage.

Change in Medicare eligibility

You may enroll in a Medicare medical plan when you become Medicare eligible. If you and/or your dependent are already enrolled in non-Medicare medical coverage through the ASRS, you and/or your dependent must switch to a Medicare plan upon becoming Medicare eligible. Failure to enroll in a Medicare plan will result in the termination of coverage for you and/or your dependent. If this occurs, you may not be able to re-enroll in an ASRS medical plan unless you have a Qualifying Life Event or until the next Open Enrollment Period. 

Please note: Medicare eligibility is NOT a Qualifying Life Event for dental plans - only for medical plans.

Your enrollment application must be submitted within 90 days of your Medicare eligibility date. Coverage will be effective on the first day of the month you become Medicare eligible if your enrollment application is submitted prior to the effective date or on the first day of the month after the enrollment application has been received.

If you are already enrolled in a Medicare Advantage plan you may be able to make changes to your plan outside of the annual Open Enrollment Period in other special circumstances. Please refer to Medicare.gov for more information regarding special circumstances. 

You can also talk with a Medicare specialist by calling (800) 432-4040 if you reside in Arizona, or you can check the Medicare.gov website for contact information if you reside outside of Arizona.  

Loss of other coverage (spouse, employer, COBRA)

You may enroll in a plan, change plans and/or add dependent coverage when:

    • you or your dependent has lost group or individual health insurance coverage due to a loss of eligibility for the coverage (including termination of employment or reduction in hours, but not including a failure to pay premiums or voluntary termination of coverage), 
    • the group medical plan option in which you or your dependent are enrolled terminates,
    • the employer sponsoring the group medical plan in which you or your dependent are enrolled ceases making contributions towards the costs of coverage, or
    • you or your dependent exhaust COBRA continuation coverage.

Please note:  You may be asked to provide documentation that supports the qualifying event. Voluntarily terminating your non-ASRS group or individual medical insurance plan is not a qualifying event.

Your enrollment application must be submitted within 31 days of the date of your qualifying event. Coverage will be effective on the first day of the month after you submit your enrollment application.

Change Relating to Medicaid or Children's Health Insurance Program (CHIP)

If you or your dependents become eligible for a Medicaid or CHIP subsidy or lose coverage under Medicaid or CHIP, you may enroll in a plan, change plans, and/or add or remove dependent coverage. Supporting  documentation may be required.

Your enrollment application must be submitted within 60 days of the date you or your dependent is determined to be eligible for the subsidy or the date coverage is terminated. Coverage will be effective on the first day of the month after you submit your enrollment application.

To select this Qualifying Life Event in the ASRS online system, choose ?Loss of Other Coverage? in the dropdown menu of choices. 

Long Term Disability

If you are approved for the ASRS Long Term Disability Program, you may enroll yourself and your dependents in any plan for which you are eligible. Supporting documentation will not be required, unless you wish to cover a dependent child over the age of 26.

Your enrollment application must be submitted within 31 days of your disability benefit effective date. Coverage will be effective on the first day of the month after you submit your enrollment application.

For more about ASRS Retiree Health Insurance, please refer to our Healthcare section.

Heathcare

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