Qualifying Event can be any of the following:

  • Change in legal marital status, including marriage, death of a spouse, divorce, legal separation and annulment.
  • A change in the number of dependents, including birth, death, adoption and placement for adoption.
  • A change in employment status of the member’s dependent spouse and/or adult dependent, including termination or commencement of employment, a strike or lockout, a commencement of or return from an unpaid leave of absence, a change in work site, or a change in employment status which results in a change in benefits s/he receives or is eligible to receive.
  • A change in the employment status of the member’s adult dependent child that results in loss of access to employment-based group insurance.
  • A dependent’s loss of eligible status.
  • A change in the place of a dependent’s residence making the current Plan unavailable.
  • Open enrollment under the Plan available through the dependent spouse’s employer.
  • Judgments, decrees or orders.
  • Significant cost or coverage changes under the member’s Plan.
  • Entitlement to Medicare or Medicaid.

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Local: 603.669.4771
Fax: 603.666.4477

Allegiant Care
51 Goffstown Road
P.O. Box 4604
Manchester, NH 03108

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