Making Changes to Your Elections
Qualified Transportation Expense (QTE) Plan and Tax-Deferred Annuity (TDA) Plan
Changes to these plans may be made each month by completing and submitting a QTE Enrollment/Change Form and/or a Salary Reduction Form (TDA Plan) found in the Benefits Forms and Documents page. Your change will take effect on the first of the month you have indicated at the top of the form or the first of the month following receipt of your completed form if no date is indicated. Forms may be scanned and emailed to email@example.com, or sent via U.S. Mail or interoffice mail to The Office of Human Resources/Benefits, 79 Fifth Avenue, 18th Floor, New York, NY 10003, or faxed to 212.229.5884.
Health Care Plan, Dental Care Plan, and Flexible Spending Account Plan
Generally, you may only change your elections for these plans during the university's Annual Open Enrollment period. However, you may change your elections during the calendar year if you have a Change in Status as defined by the Internal Revenue Code. Change requests must be made no later than 31 days after the date of the status change as described below:
- Marital Status Change: Marriage, death of spouse, divorce or annulment, legal separation
- Dependent Status Change: Birth, adoption or placement for adoption, death of dependent child, newly eligible dependents due to plan design change, dependent no longer eligible according to the terms of the plan, loss of student status, marriage of dependent child
- Loss of Coverage: Employee or dependent loses other coverage
- Employment Status Change of the employee, spouse, or dependent child: Commencement or termination of employment, commencement or return from an unpaid leave of absence, change in employment classification that affects the individual’s eligibility under the plans, and change in work site
- Judgments, Decrees and Orders: You or another individual is required to provide health coverage for your dependent child(ren).
- Other: Establishing a domestic partnership with a state or local municipality, or termination of a domestic partnership or change in residence of the employee, spouse, or dependent child(ren)
- For a Dependent Care FSA only: The provider of the dependent care changes or your cost for dependent care significantly increases or decreases
In the case of the birth of a child, the change becomes effective on the child's date of birth. All other changes become effective the first of the month following the event.
Note: If you and/or your qualified dependent(s) lose eligibility under CHIP (Children's Health Insurance Program) or Medicaid, or are determined to be eligible for state premium assistance under either the CHIP or Medicaid programs, you and your qualified dependents have 60 days from the date coverage ends or the eligibility determination date to enroll or end coverage.
If you and/or your dependent(s) experience a Change in Status:
- You must complete and submit a Health Care, Dental Care and/or Flexible Spending Enrollment/Change Form as applicable. The forms can be downloaded from the benefits forms and documents page.
- You must submit documentation that supports the Change in Status which contains the date the change is effective (e.g. letter from a spouse or domestic partner’s employer indicating loss of coverage).
- You must submit a copy of supporting dependent documentation if not already on file with Human Resources such as a marriage certificate, child’s birth certificate, or the Statement of Domestic Partnership (PDF).
Forms may be scanned and emailed to firstname.lastname@example.org; sent via U.S. Mail or interoffice mail to The Office of Human Resources/Benefits, 79 Fifth Avenue, 18th floor, New York NY 10003; or faxed to 212.229.5884.