The elections you make during Annual Enrollment will remain in effect for the plan year until the next Annual Enrollment period, January 1 through December 31 each year. If your life or family status changes during that time, however, you may be permitted to change your benefits coverage to accommodate your new situation. If you've enrolled in a plan, you cannot change your election but may modify the level of your coverage. Generally, you may change your elections if:
If any such event occurs, within 31 days of the event, you need to complete
an Enrollment/Change Form. You may be required to provide documentation
verifying the change. The chart below shows some examples of enrollment
changes permitted by a change in your life or family status.
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Medical
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Life Ins.
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Dependent Care
Assistance
Account
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| Marriage/Domestic Partnership |
Employee may enroll newly eligible spouse/domestic partner
and dependent children |
May enroll spouse/domestic partner subject to evidence of insurability and/or dependent children without
evidence of insurability. |
May enroll or increase to accommodate newly acquired dependents, decrease
or cease spouse/domestic partner coverage if they are not employed. |
Divorce or Death
of Spouse/Domestic Partner, Legal Separation or Annulment |
May revoke election only for spouse/ domestic partner where
applicable. Employee may elect coverage for self or dependents
who lose eligibility under spouse/domestic partner's plan if such individual
loses eligibility as a result of the divorce, legal separation, annulment
or death. |
Employee may increase optional subject to evidence of insurability.
May drop spouse/domestic partner or increase dependents subject
to evidence of insurability. |
May enroll, or increase to accommodate newly eligible dependents( e.g.,
due to divorce from non-working spouse) or decrease or cease coverage if
eligibility is lost due to an event (e.g., dependent now resides with ex-spouse). |
| Death of Dependent or Spouse/Domestic Partner |
Employee may drop coverage only for the dependent or spouse/domestic partner who becomes deceased. |
May drop coverage of dependent or spouse/domestic partner. |
May decrease or stop election for a dependent who becomes deceased. |
Birth/Adoption
(Adoption certificate
required) |
Employee may elect or increase coverage for newly acquired dependent
and any other dependents who were not previously covered. |
May add coverage without evidence of insurability. |
May enroll or increase to accommodate newly eligible dependent(s). |
Spouse, Domestic
Partner Begins
Employment or Other Employment Event (e.g., going from part-time
to full time with benefits) |
Employee may revoke election for employee, spouse/domestic
partner, or dependent coverage if employee, spouse/domestic partner,
or dependent is added to spouse/domestic partner's coverage. |
Changes can only be made subject to evidence of insurability. |
Employee may make or increase election to reflect new eligibility (if
spouse/domestic partner previously did not work or if their work
has changed such as part-time to full-time). |
Spouse,
Domestic Partners Termination or Other Change in Employment
Such as Unpaid Leave, Full-time to Part-time, Strike Resulting in
Lost Eligibility. |
Spouse/domestic partner and or dependents may be added to
employee's plan. |
Changes can only be made subject to evidence of insurability. |
May enroll or decrease the election. |
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