Loyola University Chicago

Human Resources

Reporting Your Qualified Life Event

Reporting Your Qualified Life Event

Election changes due to status changes must be made no later than 31 days from the effective date of the qualifying life event (loss of coverage, birth of child, etc.). Please find below information to help guide you through Loyola’s benefit enrollment process for a qualified life event.
  1. You may initiate your change by submitting a Benefit Enrollment Form to benefits@luc.edu
  2. Submit supporting documentation to verify your qualified life event. *See the bottom of this page for more information about supporting document requirements to verify your life event.
  3. If adding dependents to your benefits, submit supporting documents to verify their dependent eligibility. Please see page 7 of the Benefits Booklet located in the resources section (upper right) of this page for more information about documents (i.e. birth certificate, marriage certificate) you will need to provide in order to enroll dependents for benefit coverage.
  4. If applicable, to prevent a spousal surcharge, please review and complete the Surcharge Waiver form.
  5. Submit the Benefit Enrollment Form and all supporting documentation to the Human Resources department through email at benefits@luc.edu
  6. A Benefit Specialist will follow-up with you after we receive the enrollment form, the supporting document verifying the qualifying event, and the spousal waiver form and dependent verification supporting documentation, if applicable.
Additional Information
  • Monthly premium rates are located in the in the Resources section (upper right) of this page.
  • The Benefits Booklet detailing our benefit plans is located in the Resources section (upper right) of this page.
  • The request for coverage change must be made within 31 days of the change in status or event. If the request is not made within 31 days of your change in status or event, you will not be allowed to change your coverage until the next annual open enrollment period.
  • Any change in your deductions (if applicable) will be effective the first pay period following the change.
*Supporting Document Requirements to Verify your qualified life event: 
  • Birth or Adoption: A birth certificate or birth notice from the hospital, or an adoption agreement.
  • Marriage: A marriage certificate. If you are dropping your health coverage because you have been added on to your new spouse’s coverage as a result of your marriage you must report a Gain of other Coverage life event, not a marriage event.
  • Divorce: A divorce decree or a notice of legal separation.
  • Change to Spouse Benefits/Eligibility: If your spouse/LDA has gained new coverage: A letter on company letterhead stating the date that your new coverage became effective, the types of coverage that have been gained (for example – medical, dental, and vision coverage), and the names of the affected dependents. If your spouse/LDA lost their coverage: A letter on company letterhead stating the date that coverage terminated, the types of coverage that have been lost (for example – medical, dental, and vision coverage), and the names of the affected dependents. A complete COBRA notice including all of the required information previously listed is also acceptable.
  • Death: A death certificate.
  • Loss of Other Coverage: A letter on company letterhead stating the date that your coverage terminated, the types of coverage that have been lost (for example – medical, dental, and vision coverage), and the names of the affected dependents. A complete COBRA notice including all of the required information previously listed is also acceptable.
  • Gain of Other Coverage: A letter on company letterhead stating the date that your new coverage became effective, the types of coverage that have been gained (for example – medical, dental, and vision coverage), and the names of the affected dependents.