State of Maine Employee Health & Benefits: Life Events and Family Status Changes

Outside of the annual open enrollment period, changes can only be made to your health, dental and vision insurance plans if you experience a certain "life event."  This rule also applies to the Flexible Spending Accounts and is governed by the IRS.  Request for change must received within 60 days of the date of the life event.

Please note:  If you cancel your entire health insurance contract based on any of the events listed below this may affect your health insurance benefits in retirement. 

If you don't see your particular situation listed below or have any questions, please call Employee Health & Benefits at (207) 624-7380 or 1-800-422-4503.

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Life Event
Documentation Required
Changes Allowed
Marriage
None You may add any or all family members
Divorce
None It is mandatory to remove your ex-spouse & stepchildren.  It is considered fraud to cover these members on your existing policy after divorce.  Other family members may also be removed.
End of Domestic Partner Relationship
None It is mandatory to remove your domestic partner and the partner's children. Other family members may also be removed.
Dependent child turning 2 years of age
None You may add your dependent child effective the 1st of the month following the child's 2nd birthday.  This applies to the dental plan only.  The application for change must be received by Employee Health in the month prior to the change.
Birth of a child
None You may add any family members.
Adoption of a child
Court documentation You may add any family members.
Death of a spouse, qualified domestic partner or dependent
Copy of death certificate if deceased more than 1 year You may remove any or all family members.
Termination of employment & loss of insurance coverage by spouse, partner or dependent
Notice from former employer stating insurance coverage end date and reason You may add any or all family members who suffered the loss of insurance.
Involuntary loss of coverage
Notice from employer stating insurance end date and reason You may add any or all family members who suffered the loss of insurance.
Becoming eligible for MaineCare
  You may remove any or all family members or cancel the entire contract.
Loss of MaineCare
Notice from MaineCare stating no longer eligible with an effective date You may add any or all family members who suffered the loss of insurance.
Change in employment status by employee, spouse, qualified domestic partner or adult child
None

Examples include: Change in number of hours worked, work assignment ends, become eligible for own policy, start/return from unpaid or seasonal leave of absence, acting capacity status to permanent regular status, etc.

Request must be consistent with the event.  For example, if changing from part-time to full-time you may enroll yourself or add family members. However, if changing from full-time to part-time you may remove family members or cancel entire contract.

COBRA insurance policy ends
COBRA cancellation notice You may add any or all family members who suffered the loss of insurance.
Spouse's annual enrollment
None You may remove any or all family members or cancel entire contract.  (Additions are not allowed.)
Court order
Court document(s) Change must be consistent with the order to add or remove your dependent(s).
Domestic partner relationship - 6 month period met
Domestic partner affidavit and supporting documents  
Incarceration (for one month or more)
  You may remove any or all family members or cancel the entire contract.
Military service (employee)
  You may continue coverage for all covered members or just yourself.  You may remove any or all family members or cancel the entire contract.