Gain Or Loss Of Coverage

You can add, change or remove benefit coverage outside of annual enrollment if these qualifying life events occur to you:

    • Loss or gain of coverage due to a change in your own employment status
    • Loss or gain of coverage due to a change in your spouse’s employment status
    • A change in working conditions (including changing between part‐time and full‐time or hourly and salary)

How To Make Changes To Your Benefits

  1. Review the benefits you can change. To see the details of the benefits,click on the benefit below
  2. Review the supporting documents required below
  3. Download and fill out Enrollment Form
  4. Bring supporting documents and completed enrollment form to Human Resources
  5. All forms must be received within 30 days of the date of the event and will take affect the 1st of the month following the event.

Plans You May Be Able To Change
Medical
Dental
Vision
Health Care FSA
Dependent Day Care FSA
Supplemental Life Insurance
Supplemental Life for Your Spouse
Supplemental Life for Dependent Children

Supporting Documents

When making mid year benefit changes due to gain or loss of coverage you are required to submit supporting documents to Human Resources prior to approval.

Examples of supporting documentation and actions (not all inclusive)

Action

Supporting Documentation Needed
Add spouse or dependents to our plansTermination Letter/Proof of Loss of Other Coverage
Remove self, spouse, or dependents from our plansProof of New Coverage for anyone being dropped from the plan including coverage effective date

Change Your Benefits Rectangle

Change Your Benefits
Overview
Birth & Adoption
Marriage
Divorce or Annulment
Death & Survivorship
Gain or Loss of Coverage