Qualified Status Changes

Only certain life events count as a Qualified Change in Status. It’s important to understand thisbecause you can only make a change to your election during the year if you have experienced one of the following:
> A change in your marital status (such as marriage, divorce or annulment);

> A change in the number of your dependents for tax purposes (such as birth, legal adoption, of your child, placement of a child with you for adoption, or death of a dependent)

> Certain changes in employment status that affect benefits eligibility, for you, your spouse or children, such as: termination of employment, a strike or lockout, or a change in work schedule (for example, a switch between full-time and part-time work)

> Your child no longer meets the benefit plan’s eligibility requirements

> Entitlement to Medicare (including Part B and Part D) or Medicaid (applies only to the person entitled to Medicare or Medicaid)

> Change to comply with a state domestic relations order or Qualified Medical Child Support Order (QMCSO) pertaining to coverage of your dependent child

> You, your spouse or child become eligible for COBRA coverage

> A change in your, your spouse’s or your child’s place of residence

> A significant increase in the cost of coverage or a significant reduction in the benefit coverage under your or your spouse’s healthcare plan*

> The addition, elimination, or significant curtailment of a coverage option*

> A change in your spouse’s or child’s coverage during another employer’s annual enrollment period when the other plan has a different period of coverage* or

> A change in dependent care providers or costs if the providers are not your relatives.**

* These changes in status do not apply to the Health Care Reimbursement
Account (36 Phlex Plan participants only).

** Applies only for Dependent Care Reimbursement Account (36 Phlex
plan participants only). If you experience any of the changes listed above, you must notify the Fund office in writing within 31 days of the change and you must provide proof of the event.

If you have any questions or are still unsure of what you need to supply, please contact the Funds Office at 215-568-3262 or 1-800-338-9025 if you are outside the area so one of our customer service representatives can assist you.