What happened?  

Correct Reason 

I got married. 

Employee/Retiree gets married 

I got divorced/annulment. 

Employee/Retiree gets divorced 

My child got married. 

Child gets married 

My dependent or I had a baby. 

Birth of a child 

I gained a dependent because: 

• I fostered a child, 
• I adopted a child, or 
• A court appointed me to be a child’s guardian. 

Gain Adopted/Foster/Ward child 

My dependent passed away. 

Death of dependent 

My dependent or I had an employment change. 

Change in employment status 

My dependent became eligible for insurance after a waiting period. 

Dep eligible after waiting period 

My dependent moved out of my HMO or dental service area. 

Dependent leaves HMO area 

My dependent or I gained eligibility for Medicare, Medicaid, or Children’s Health Insurance Program (CHIP). 

Medicare/Medicaid eligible 

My dependent or I lost eligibility for Medicare, Medicaid, or CHIP. 

Medicare/Medicaid ineligible 

We had a significant change in costs due to: 

• approval for SKIP or Health Insurance Premium Payment (HIPP) Program. 
• loss of SKIP or HIPP eligibility (does not include SKIP expiration). 
• increase in day care costs. 
• increase in other health or dental insurance that does not include GBP insurance. 

Significant change in cost 

A court ordered me to provide health insurance for my spouse or child. 

Employee/Retiree gains MSO 

A court order to cover my spouse or child expired. 

Employee/Retiree loses MSO 

My dependent:  

• lost eligibility for my GBP coverage. 
• lost eligibility for other insurance coverage. 
• became eligible for my GBP coverage. 
• became eligible for other insurance coverage. 

Dep eligibility change 

I can no longer claim on my income tax a child who is related to me by blood or marriage. This does not include my biological, adopted, foster, step- or ward child. 

Child loses eligibility