Special Enrollment Periods for Employees — Qualifying Life Events (QLE)

In general, members of pre-tax group health plans can only change benefits once a year during the open enrollment period, as outlined in Section 125 of the Internal Revenue Code.

The exception to this rule is a special enrollment period known as a qualifying life event (QLE). Through QLEs, the IRS provides specific instances when employees can evaluate and change their elections mid-year to adjust for life’s changes. 

QLE details are listed in your company’s Summary Plan Description (SPD) documents. If you do not see your employees specific situation please contact our Admin Support Team (admins@sanabenefits.com) and we will help you determine next steps.

Common qualifying life events:

  • They got married/entered into a Domestic Partnership/common law marriage
  • They got divorced/legal separation
  • Birth/Adoption/Legal Guardianship
  • They/their dependent lost their existing health insurance coverage
  • They/their dependent gained other health insurance coverage
  • They/their dependent gained coverage under Medicaid or CHIP
  • They/their dependent gained coverage through Medicare
  • Court-ordered Enrollment Change
  • Death of a dependent


If the employee is eligible for benefits and has satisfied the company’s established waiting period, they have 31 days after the qualifying event to request a change.

Getting Started

  • Refer the employee to our Member Help Center article on Qualifying Life Events. Here they will find instructions on submitting changes from their Sana account. Reminder: Employees have 31 days after a QLE to make updates. 
  • Once the employee has updated their elections, the QLE will appear as a pending enrollment in your admin dashboard. 
  • Visit the admin dashboard to review and approve pending enrollments.
  • Once approved, benefits will start or end on the date of the QLE.
  • Sana does not prorate premiums.

 Important Notes:

  • QLE changes cannot be made/requested before the event happens. Changes can only be made on the day of the event or within the 31 days following the event. 
  • If your employee was not previously eligible for benefits, they are required to satisfy the company’s waiting period prior to coverage. For example, if a part-time employee moves to full-time, the coverage start date is calculated using the full-time employment date. Follow the steps for adding a new hire to begin their enrollment process. 

Have questions? We've got you covered.

Connect with Customer Support directly through the chat icon on most Sana pages, email admins@sanabenefits.com, or call (940) 340-4488 Monday through Friday, 10 AM to 5 PM Central.