A Qualifying Life Event (QLE) is a significant life change — whether planned or unexpected — that can impact your health insurance. Experiencing a QLE may allow you to adjust your health plan outside of the annual enrollment period (also known as open enrollment). For more information, check out the article What is a QLE?
Election changes can also be made to your FSA, LPFSA, or DCFSA benefits following a QLE. Typically, additional funds become available only for expenses incurred on or after the effective date, which usually aligns with the first payroll following QLE approval.
For example, let’s say Janet elects $1,000 for her FSA at the beginning of the plan year and carries over $150 from the previous year. In April, Janet gets married, qualifying her to make an election change that will take effect on May 1. She increases her FSA election to $3,000.
- She can claim $1,150 for expenses incurred between January 1 and April 30.
- She can claim up to $3,150 for expenses incurred on or after May 1.
- If Janet has a $2,000 expense in March, she can only be reimbursed for $1,150 of it. This is because she will not have access to the additional $2,000 (due to the QLE) until May 1.
If the QLE involves adding a dependent, the effective date will be retroactively aligned with the date of birth, adoption, or adoption placement.
Please note: You cannot decrease your FSA, LPFSA, or DCFSA elections to a level where the total amount for the benefit period falls below what has already been spent or contributed.