Enrolling in the Plan

You must complete and file an enrollment form with the Administrative Office whenever you change your address, add, or drop dependents. You will need to fill in your address, the names of your eligible dependents, and the name of your beneficiary for your life insurance benefits. Remember to update your enrollment form anytime a change occurs.

If you terminate employment and later return to work, you must re-enroll, or your coverage will automatically be defaulted to the Self-Funded Plan unless there is no Self-Funded Plan available. Payment of claims will be delayed if you do not keep this information current.

Document Required in Order to Enroll Dependents 

To enroll your spouse, you must furnish a copy of your marriage certificate with the Plan enrollment form. If you divorce, your ex-spouse and stepchildren lose coverage upon entry of a final divorce decree (see COBRA COVERAGE).  If you divorce you must inform the Plan. You must furnish a copy of the divorce decree with the revised enrollment form that excludes your former spouse. It is fraud to continue coverage for your ex-spouse after you divorce.