If Your Personal Life Changes

We’re not mind readers, although we’re fans of Penn & Teller and got a great deal on a OUIJA™ board. We’re not curious by nature, although we’re dying to know if you got married…why weren’t we invited to the wedding? Birth, death, divorce, marriage, loss of other coverage, new coverage…these are all examples of life events that we need to know about because they could impact your health coverage (for a complete list, please refer to the Summary Plan Description).

The benefit elections you make during your initial eligibility window or for Open Enrollment stay in effect throughout the entire plan year (August 1 - July 31). To make mid-year changes, you must take action within 30 days of the life event. Once a coverage change has been approved, it generally becomes effective on the first day of the month following the date you submit your status change, as long as you submit the status change within 30 days. If your qualified change in status involves a newborn or newly-adopted child, coverage begins on the date of birth or adoption as long as you submit your status change within 30 days of the date of birth or adoption.

• Submit secure a Benefits Change Form to change existing coverage. Submit secure a Benefits Enrollment Form to enroll in new coverage. Submit secure a Flexible Spending Account (FSA) Form to enroll if you’re eligible. Save first in your computer, then upload to our Secure Web Link for Employee Forms.

• Submit supporting documentation. Some examples include copies of:

  • your marriage certificate

  • the first page of your final divorce papers

  • the birth record given to you in the hospital

  • a copy of the death certificate

  • proof of the date of the loss of other coverage

  • proof of the date of new coverage

  To add a Domestic Partner, submit secure the Domestic Partner Affidavit along with the Benefits Change Form.

Got Questions? Call Benefits at (818) 972-8914