Quick Reference Guide for Qualifying Life Events (QLE) 

    The Flexible Spending Account (FSA) / Section 125 Program
    Qualifying Life Events and the FSA / Section 125 Program
    The FSA/Section 125 program is a tax-savings plan governed by the rules of Section 125 of the Internal Revenue Code. An important rule for Section 125 plans is that you cannot change your election to participate during the calendar year unless you or your dependent(s) experience a Qualifying Life Event (QLE). Elections that are not eligible to be changed without a QLE include medical, dental, vision, Health Care Flexible Spending Account (HCFSA) and Dependent Care Flexible Spending Account (DCFSA).  
    What is a Dependent?  
    Dependent means a covered employee's:
    1. Legally recognized spouse;
    2. Common law spouse;
    3. Natural blood-related child, step-child, legally adopted child or child placed with the employee for adoption, foster child, a child for which the employee has legal guardianship, children of a qualifying individual,common-law or children of a common law spouse whose age is less than the limiting age. The limiting age for each dependent child is the end of the month when he or she attains the age of 26 years. Your child is covered to the limiting age regardless if the child is:
      1. Married
      2. Tax Dependent
      3. Student
      4. Employed
      5. Residing with or receiving financial support from you
      6. Eligible for other coverage through employment 
    4. A covered employee's child whose age is less than the limited age and is entitled to coverage under the provisions of this Plan because of a medical child support order;
    5. Grandchild, as long as the employee's covered dependent, who is the parent of the grandchild is not yet 26;
    6. Qualifying Individual - Both Same and Opposite Sex
    What is a Qualifying Life Event?
     A Qualifying Life Event is an event defined by the Internal Revenue Service in Section 125 that allows you to change your election. QLEs include:
    • Loss of health coverage under another employer plan (including the exhaustion of COBRA coverage)
    • Change in your legal marital status (i.e, marriage, legal separation or divorce)
    • Acquiring a dependent through birth, adoption, or becoming the legal guardian
    • Death of spouse or child
    • Dependent satisfies or ceases to satisfy dependent eligibility requirements
    • Change in employment status (for employee, spouse, or employee's dependent) that affects eligibility for health insurance benefits (spouse obtains coverage or loses coverage)
    • Entitlement or loss of Medicare or Medicaid
    I have a Qualifying Life Event. What do I do now?
    To make a change, you must notify the PfISD Benefits Department within 60 calendar days of the applicable event. Documentation will need to be received and enrollment/change documents completed within this time frame. Contact the PfISD Benefits Department at benefits@pfisd.net or 512-594-0026 for more information and to obtain the enrollment/change documents.  
    Notification and Effective Date of Coverage
    Payroll changes will be effective on the first pay period following approval of your QLE.  If the QLE is due to the birth of a child, your effective date will be retroactive to the date of the event even though your new deduction amount will not go into effect until the first pay period following approval. Any change in the amount deducted from your paycheck cannot be retroactive unless it’s due to the birth of a child.