Making Changes To Your Benefits

MAKING CHANGES TO YOUR BENEFITS

When You Can Make a Change

Having a baby? Checkout this guide.
  • During the Year: Due to federal laws, you can only make changes to your benefits throughout the year if you have an eligible work or life event, called a qualifying status change. When you have one of these events (such as a birth or going full-time), you have within 31 days of your event date occurring to make your benefit changes online and provide documentation. Details are in the next section. 
  • Annual Benefits Enrollment: All benefits eligible employees can make changes to their benefits during each annual Benefits Enrollment period. When you make changes to your benefits during Benefits Enrollment (which is usually in November each year), the changes are effective January 1 of the next year.

 

Qualified Status Changes

Life Events

Event

Description

Documentation Requirements

Deadline to Enroll & Submit Documents

Date Change is Effective

Adoption

An employee gains a child due to an adoption.

Finalized adoption decree signed and dated by presiding judge
              -OR-

Paperwork showing a child has been placed for adoption

Within 31 days of event date

Date of the event

Birth

An employee gains a child due to a birth event.

Birth Certificate

             -OR-

Verification of birth facts

Within 31 days of event date

Date of the event

Divorce

An employee has legally been divorced from his/her spouse.

1st and last page of finalized divorce decree signed by presiding judge

 

Within 31 days of event date

Date of the event

Gain of other coverage (Employee, spouse or child)

Employee, spouse, or child gains coverage elsewhere.

Document or letter from the other employer or insurance company showing the names of those gaining coverage elsewhere and date coverage begins.

Insurance cards are NOT accepted

Within 31 days of event date

The pay period begin date after changes are made online and applicable documentation is submitted.

Guardianship or legal custody of a child

An employee has been granted legal custody of a child or a managing conservator.

Copy of court order signed and dated by presiding judge

 

Within 31 days of event date

Date of the event

Loss of other coverage (Employee, spouse or child)

Employee, spouse, or child loses coverage elsewhere.

Document or letter from the other employer or insurance company showing the names of those losing coverage elsewhere and date coverage ended.

Standard dependent verification requirements for any newly added dependents

Within 31 days of event date

The pay period begin date or the first of the month after changes are made online and applicable documentation is submitted, whichever is sooner.

Marriage

An employee has legally been married.

A legal marriage license

*Proof of shared address is not required for a newly married spouse

Within 31 days of event date

The pay period begin date or the first of the month after changes are made online and applicable documentation is submitted, whichever is sooner.

Work Events

Event

Description

Documentation Requirements

Deadline to Enroll & Submit Documents

Date Change is Effective

Newly Eligible for coverage

An employee changes from a Non-Benefits Eligible position.

Standard dependent verification requirements for any newly added dependents

Within 31 days of event date

The pay period begin date after changes are made online and applicable documentation is submitted, as long as you have had 30 days of service.

Part Time to Full Time

An employee changes from a Part Time Benefits Eligible Benefits position to a Full Time Benefits Eligible position

Standard dependent verification requirements for any newly added dependents

 

Within 31 days of event date

The pay period begin date after changes are made online and applicable documentation is submitted.

Full Time to Part Time

An employee changes from a Full Time Benefits Eligible Benefits position to a Part Time Benefits Eligible position

None

 

 

Within 31 days of event date

The pay period begin date after changes are made online and applicable documentation is submitted.

 

How to Make a Change Online

  1. Go to www.MyTHR.org.
  2. Click  the “Benefits” tile.
  3. Make your applicable changes to your benefits based on your event.
    • Please know that according to legal guidelines, your changes must be consistent with the event you experienced.
  4. You must provide documentation within 31 days of your event date, or the changes you made to your benefits will not take effect.
  5. Submit your documentation to Texas Health Benefits Support via email to THRBenefitsSupport@texashealth.org.
  6. Please include this cover sheet when submitting documentation.