What is a qualified status change and how does it impact my MetLife OTL coverage?
A qualified status change is an event to your family, employment, or coverage status. If you have a qualified status change, you must call the IBM Benefits Center – Provided by Fidelity within 45 days of the date of the qualified status change, otherwise you will not be able to take advantage of the lessened medical review requirements associated with certain qualified status changes, which are noted below.
Please note: Changes to accidental death and dismemberment insurance for yourself or your dependents never require a medical review.
| Qualified Status Change | What Coverages can be Changed? |
Effective Date of Coverage Changes |
Medical Review Requirements |
| Marriage or entering into a domestic partnership | May change coverage elections for employee and dependents. | Changes are effective retroactively to the event date | Employees: Can increase term life insurance by 1 increment without a medical review, up to 3 times coverage or $750K, whichever is less. Employees may enroll for additional coverage by answering some medical questions.1 Spouse/Domestic Partner: Can enroll for term life insurance up to $50,000 without a medical review.Spouses/domestic partners may enroll for additional coverage by answering some medical questions.1 Children: No medical review is required. |
| The birth, adoption, or placement for adoption of a dependent child | May change coverage elections for employee and dependents. | Changes are effective retroactively to the event date | Employees: Can increase term life insurance by 1 increment without a medical review, up to 3 times coverage or $750K, whichever is less. Employees may enroll for additional coverage by answering some medical questions.1 Spouse/Domestic Partner: Can enroll for term life insurance up to $50,000 without a medical review.Spouses/domestic partners may enroll for additional coverage by answering some medical questions.1 Children: No medical review is required. |
| The employee’s dependent's ceasing to qualify as a dependent under this insurance or under other group coverage | May decrease coverage elections for employee, spouse, and children other than the dependent ceasing to qualify. Coverage for dependent ceasing to qualify would terminate | Changes are effective the first of the month following the event | N/A |
| The death of a dependent | May decrease coverage elections for employee, spouse, and children other than the deceased dependent. Coverage for deceased dependent would terminate |
Changes are effective the first of the month following the event | N/A |
| Divorce, legal separation, or annulment | May change coverage elections for employee and children. Coverage for spouse would terminate | Changes are effective the first of the month following the event. | Employees: Can increase term life insurance by 1 increment without a medical review, up to 3 times coverage or $750K, whichever is less. Employees may enroll for additional coverage by answering some medical questions.1 Spouse/Domestic Partner: N/A. Children: No medical review is required. |
| A change in the employee’s or the employee’s dependent's employment status, such as beginning or ending employment, strike, lockout, taking or ending a leave of absence, changes in worksite or work schedule, if it causes the employee or the employee’s dependent to gain or lose eligibility for group coverage | May change coverage elections for employee, spouse, and children |
Changes are effective the first of the month following the event |
Employees: A medical reviewis required for any increase.1 Spouse/Domestic Partner: Can enroll for term life insurance up to $50,000 without a medical review.Spouses/domestic partners may enroll for additional coverage by answering some medical questions.1 Children: No medical review is required. |
| A change in the employee or the employee’s dependent's residence, if it causes the employee or the employee’s spouse to gain eligibility for group coverage | May change coverage elections for employee, spouse, and children |
Changes are effective the first of the month following the date the employee requests the changes | Employees: A medical review is required for any increase.1 Spouse/Domestic Partner: Can enroll for term life insurance up to $50,000 without a medical review.Spouses/domestic partners may enroll for additional coverage by answering some medical questions.1 Children: No medical review is required. |
| A change in the employee or the employee’s dependent's residence, if it causes the employee or the employee’s dependent to lose eligibility for group coverage | May change coverage elections for employee and dependents | Changes are effective retroactively to the event date | Employees: A medical review is required for any increase.1 Spouse/Domestic Partner: Can enroll for term life insurance up to $50,000 without a medical review.Spouses/domestic partners may enroll for additional coverage by answering some medical questions.1 Children: No medical review is required. |
1 When medical questions are required, MetLife will evaluate your request for coverage based upon your answers to the health questions, MetLife’s underwriting rules and other information you authorize us to review. In certain cases, MetLife may request additional information to evaluate your request for coverage.