How Qualifying Life Events May Allow You to Change Your FEHB Plan Outside of Open Season

Have you recently experienced an exciting life event, like getting married or having a baby? A significant life event like these may make you eligible to make changes to your health plan outside of Open Season.  

The last thing you want to worry about when making a major life change is your health insurance. So, we put together helpful information on how you may be eligible to change your health plan during the year.  

What is a qualifying life event?  

You may have heard the term “qualifying life event” from your agency’s human resources officer or from your health plan but may not understand what it means. To help clarify, the following are the different types of qualifying life events (QLEs) under the Federal Employees Health Benefits (FEHB) Program:

A change in family status:

• marriage
• birth or adoption of a child
• acquisition of a foster child
• legal separation
• divorce
• death of a spouse or dependent 

• you are reemployed after a break in service of more than 3 days
• you return to pay status after your coverage terminated during leave without pay status or because you were in leave without pay status for more than 365 days
• your pay increases enough for premiums to be withheld
• you are restored to a civilian position after serving in the uniformed services
• you change from a temporary appointment to an appointment that entitles you to a Government contribution
• you change to or from part-time career employment

You or a family member lose FEHB or other coverage:

• under another FEHB enrollment because the covering enrollment was terminated, canceled, or changed to Self Only
• when enrolled in a prepaid health maintenance organization (HMO) and you or a covered family member move or change worksite outside of the HMO's enrollment area
• under another federally-sponsored health benefits program
• under Medicaid or similar State-sponsored program for the needy
• under CHAMPVA, TRICARE, or TRICARE-for-Life
• when you had previously suspended your FEHB coverage to participate in one of these programs
• when your membership in the employee organization sponsoring the FEHB plan terminates
• under a non-Federal health plan

Events like getting married, having a baby or moving can affect your health insurance needs, making it important to review and adjust your health plan accordingly. A qualifying life event allows you to make necessary changes to your health plan outside of Open Season.  

Types of changes that can be made

Now that you know what a qualifying life event is, let’s uncover what types of changes can be made to your health plan when one of these events occurs. According to opm.gov, if you experience a qualifying life event, you can:

• Enroll in an FEHB plan. This is common for those who turn 26 and come off their parents' plan or for someone starting a new federal employee position.  
• Change your enrollment to another FEHB plan or coverage option. You may want to change the level of coverage you have by switching from a Standard Option plan to a High Option plan. You can also switch health plans entirely to a different FEHB provider during a qualifying life event.
• Change your enrollment. If you are expanding your family, you may want to increase your coverage from self only to self plus one or self and family.  
• Cancel your enrollment altogether. If you are retiring or joining your spouse’s plan, you may wish to cancel your FEHB enrollment entirely.

How to change your FEHB enrollment

A qualifying event is a life-changing situation and can be very exciting but also stressful if you are not prepared to change your coverage. You typically have 60 days to change your health plan status, so it is best to contact your health plan or agency’s human resources right away.  

If the qualifying life event changes your coverage — for example, adding a family member — you will need to submit the change to your employer. Any change in coverage means your premium will also change, which is why it is important to contact your employing agency, as your health plan does not have the ability to update your employer’s payroll.

After you contact your employer, your employer provides information to the health plan. Once the health plan processes the new information, the coverage changes are updated.  If your qualifying life event does not change your coverage or premiums, you can just notify your health plan.  

If you are retired, you will need to contact OPM for any qualifying life event changes.  

If you are actively employed by the Federal government, you may be able to enroll or change plans online. Our Enrollment page has information to help you better understand your options.

Making changes to your Compass Rose Health Plan

Just like any other FEHB plan, you can make changes to your Compass Rose Health Plan outside of Open Season if you experience a qualifying life event.

If you are already a member and need additional support changing your Compass Rose Health Plan coverage outside of Open Season, you can contact us.

Choosing the right fit

We know it can be hard to find a plan that checks all your boxes. We offer multiple plan options to meet our members’ needs in every stage of life, from starting your career to enjoying retirement.  

Compass Rose Health Plan options offer a nationwide network, giving you and your family access to high-quality health coverage no matter where you are. Plus, we contract with the UnitedHealthcare Choice Plus network of doctors, hospitals and other facilities, providing you and your family with high-quality providers.  

Compare Compass Rose Health Plan options, including benefits, premiums and health and wellness programs on our plan comparison page. You can also contact us if you have questions on our plans and coverage.