RYP FAQ

• Adoption
• Death in Family
• Divorce
• Employee or Dependent Gains Other Group Coverage
• Employee or Dependent Gains Medicaid or Chip Coverage
• Employee or Dependent Loses Medicaid or Chip Coverage
• Employee or Dependent Loses Other Group Coverage
• Legal Guardianship
• Marriage
• Newborn

If your event is not listed or you are unsure if it qualifies, contact the Employee Benefits Division before the deadline to determine whether your situation qualifies.

Benefit election changes during a plan year can only be made with a Qualifying Life Event.

Qualifying Life Event changes must be submitted within 31 days of the effective date of the event, with the exception of life events for Newborn, Adoption, or Medicaid/CHIP eligibility which allow a 60-day limit.

If you don’t have a qualifying life event, Open Enrollment is your annual opportunity to make changes and is typically held in October. Changes made at open enrollment are effective January 1st of the following calendar year.

No. Benefit changes must be consistent with the QLE and supported by the documentation.

Qualifying Life Event changes must be submitted within 31 days of the effective date of the event, with the exception of life events for Newborn, Adoption, or Medicaid/CHIP eligibility which allow a 60-day limit.

Your request is not complete without the supporting documentation. Supporting documentation is due within 60 days of the effective date of the event.

If changes are approved after the effective date, new/revised premium contributions may be applied retro-actively to the date of the event and applied to your upcoming paycheck(s).

If you have missed the deadline for your QLE, Open Enrollment is your annual opportunity to make changes and is typically held in October. Changes made at open enrollment are effective January 1st of the following calendar year.

QLE changes must be submitted through the Employee Benefits Portal from OnlinEnroll, umr.workterra.net, no later than the deadline.

Click the button below for full instructions on submitting QLE changes related to that event.

If your event is not listed or you are unsure if it qualifies, contact the Employee Benefits Division before the deadline to determine whether your situation qualifies.

Below is a list of supporting documentation required for QLEs. See the full instructions, including required documentation information, in the “Where can I find full QLE instructions?” section above. Additional documentation may be required depending on the event.

Adoption or Placement for Adoption

• Adoption papers/court documents

• Court order placing child pending final adoption

Death in Family

• Death certificate

Divorce

If you are adding yourself and/or dependent child(ren) to the County plans:

• Divorce decree
• If Event Date is the date of the loss of other group coverage, proof of past group insurance coverage. This documentation must identify you and/or your dependent(s), show in which plan(s) each were enrolled – medical/dental/vision – and the date coverage ends. (Example: COBRA Notification)
• If you are adding a dependent(s), proof of relationship: birth certificate for a child.

If you are dropping your ex-spouse and/or ineligible step-child(ren):

• Divorce decree

Employee or Dependent Gains Other Group Coverage

• Proof of new group insurance coverage. This documentation must identify you and/or your dependent(s), show in which plan(s) each are enrolled – medical/dental/vision – and the date coverage begins.

Employee or Dependent Gains Medicaid or CHIP Coverage

• Proof of new Medicaid/CHIP coverage. This documentation must identify you and/or your dependent(s) and the date coverage begins.

Employee or Dependent Loses Other Group Coverage

• Proof of past group insurance coverage. This documentation must identify you and/or your dependent(s), show in which plan(s) each were enrolled – medical/dental/vision – and the date coverage ends. (Example: COBRA Notification)
• If you are adding a dependent(s), proof of relationship: marriage certificate/common law affidavit for a spouse; birth certificate for a child.

Employee or Dependent Loses Medicaid or CHIP Coverage

• Proof of past Medicaid/CHIP coverage. This documentation must identify you and/or your dependent(s) and the date coverage ends.
• If you are adding a dependent(s), provide proof of relationship: marriage certificate/common law affidavit for a spouse; birth certificate for a child.

Marriage

• Copy of your marriage certificate

If you are dropping County plans, because you are enrolling on your new spouse’s plan(s):

• Copy of your marriage certificate
• Proof of new group insurance coverage. This documentation must identify you and/or your dependent(s), show in which plan(s) each are enrolled – medical/dental/vision – and the date coverage begins.

Newborn – Birth of a Child

• Birth certificate

Documentation may be attached in the Employee Benefits Portal through the QLE process in the Upload Documents screen or emailed to employeebenefits@elpasoco.com.

If you are adding the documentation in the portal after initially submitting your QLE, you may need to re-enter the QLE and attach your document(s) in the Upload Documents screen, then be sure to make it through to click the “Finish” button.

Supporting documentation is due within 60 days of the effective date of the event. However, your QLE election changes should be submitted through the Employee Benefits Portal no later than 31 days* from the event’s effective date.

Your change request will remain pending until the required supporting documentation has been received and reviewed by the Employee Benefits Division.

Effective dates will be based on the event type along with the supporting documentation.

• Divorce: 1st of the month following the date the divorce decree is filed. (Ineligible spouse and/or stepchildren’s coverage will end on the last day of the month that the divorce is finalized.)
• Gains other coverage: Date of new coverage
• Loses other coverage: Day following the last date of other coverage
• Marriage: Employee may choose an effective date of (1) the date of the marriage or (2) the 1st of the month following the date of the marriage
• Newborn: Date of birth

For questions on effective dates for your situation, please feel free to contact the Employee Benefits Division.

The Employee Benefits Division will review your QLE request and notify you via email of the decision or any required next steps within 5 business days of your submission.

To help avoid delays, if possible, submit all required supporting documentation with your request. Once reviewed, the Employee Benefits Division will notify you at your County email and, if on file, personal email of your request’s approval, denial, or if additional documentation is needed.

If additional documentation is requested, please allow up to 5 business days for your request to be reviewed after you have submitted the additional information. If further documentation is still needed, the 5 business day review period begins again for each additional documentation submission.

Children enrolled on the El Paso County plans are eligible until the last day of the month that they turn age 26.

No action is needed by the employee, the child will automatically be dropped from coverage as of that date.

Dependent children that are age 26 or more years old and primarily supported by you and incapable of self-sustaining employment by reason of mental or physical handicap that are enrolled on the plan before age 26, may continue coverage after age 26. You may be required to provide proof of the child’s dependent status to the health care plan carrier or to the Employee Benefits Division.

Contact the Employee Benefits Division no later than 31 days from the event. We’re happy to help determine whether your situation qualifies.