Your change request must be submitted within 30 days of the event. For Medicare or Medicaid, you have 60 days to request changes.

Marriage

Changes you can make to

Medical/Dental/Vision

  • Add self and other family members if adding new spouse or new dependents
  • Drop self or dependents whose coverage starts under spouse’s employer
  • Switch medical or dental plans if adding new spouse or dependents

Additional Life/AD&D

  • Add, increase, decrease or drop

Health Care FSA

  • Enroll or increase election
  • Decrease election if eligible for benefits under spouse

Dependent Care FSA

  • Enroll or increase election
  • Decrease election if new spouse isn’t employed or if participating in plan through employer
Registration for domestic partnership

Changes you can make to

Medical/Dental/Vision

  • Add self and other family members if adding new domestic partnership or new dependents
  • Drop self or dependents whose coverage starts under domestic partner’s employer
  • Switch medical or dental plans if adding new domestic partner or dependents

Additional Life/AD&D

  • Add, increase, decrease or drop

Health Care FSA

  • Enroll or increase election
  • Decrease election if newly eligible for spouse’s benefits

Dependent Care FSA

  • Enroll or increase election
  • Decrease election if new spouse isn’t employed or if participating in plan through employer
New dependents (birth, adoption, placement or adoption)

Changes you can make to

Medical/Dental/Vision

  • Add self and other family members if adding new domestic partnership or new dependents
  • Drop self or dependents whose coverage starts under domestic partner’s employer
  • Switch medical or dental plans if adding new domestic partner or dependents

Additional Life/AD&D

  • Add or increase

Health Care FSA

  • Enroll or increase election
  • Decrease election if newly eligible for spouse’s benefits

Dependent Care FSA

  • Enroll or increase election
Divorce, annulment, legal separation

Changes you can make to

Medical/Dental/Vision

  • Add self and dependents whose coverage ends under former spouse’s employer
  • Must drop former spouse except for legal separation
  • Drop legally separated spouse
  • Drop family members whose coverage starts under former spouse’s employer
  • Switch medical or dental plans if adding self or dependents

Additional Life/AD&D

  • Add, increase, decrease or drop

Health Care FSA

  • Enroll or increase election if coverage lost through spouse
  • Decrease election to reflect loss of spouse’s eligibility

Dependent Care FSA

  • Enroll or increase to accommodate newly eligible dependents
  • Cease coverage if eligibility is lost
Death of spouse

Changes you can make to

Medical/Dental/Vision

  • Add self and dependents losing coverage under spouse’s employer
  • Must drop deceased spouse
  • Switch medical or dental plans if adding dependents who lost coverage under spouse’s employer

Additional Life/AD&D

  • Add, increase, decrease or drop

Health Care FSA

  • Decrease or cease election for dependent who loses eligibility

Dependent Care FSA

    • Enroll or increase election for dependent who loses eligibility
New coverage under employer plan for you, your spouse or your child

Changes you can make to

Medical/Dental/Vision

      • Drop family members who become covered under other employer
      • Must drop deceased spouse

Additional Life/AD&D

      • Add, increase, decrease or drop

Health Care FSA

      • Decrease election if newly eligible for spouse’s benefits

Dependent Care FSA

      • Enroll or increase election to reflect new eligibility
      • Cease election if dependent added to spouse’s plan
Change in employment status for your spouse or child, resulting in loss of his or her employer plan coverage

Changes you can make to

Medical/Dental/Vision

      • Add family members losing coverage under other employer
      • Switch medical or dental plans if adding family members

Additional Life/AD&D

      • Add, increase, decrease or drop

Health Care FSA

      • Enroll or increase election to reflect dependent’s loss of health coverage

Dependent Care FSA

      • Enroll or increase election if spouse or dependent loses eligibility for dependent care
      • Decrease or cease election to reflect loss of eligibility for coverage
Election to term coverage under another employer plan during other employer's Open Enrollment or special election period

Changes you can make to

Medical/Dental/Vision

      • Add family members losing other coverage
      • Switch medical or dental plans if adding family members

Additional Life/AD&D

      • No changes permitted

Health Care FSA

      • No changes permitted

Dependent Care FSA

      • Enroll or increase based on corresponding change under employer’s plan
      • Revoke or decrease based on corresponding change under employer’s plan
Medicare or Medicaid coverage change

Changes you can make to

Medical/Dental/Vision

      • Add family members losing coverage
      • Switch medical or dental plans if adding family members
      • Drop family members who become covered under Medicare Parts A, B or D, or Medicaid

Additional Life/AD&D

      • No changes permitted

Health Care FSA

      • Decrease or cease election under employer plan
        Increase election if Medicare/Medicaid coverage is less comprehensive than employer plan

Dependent Care FSA

      • No changes permitted
Change of any family member location into or out of health plan's coverage area

Changes you can make to

Medical/Dental/Vision

      • Add family members losing coverage under other plan who have no other benefits option
      • Switch medical or dental plans if adding family members
      • Drop family members outside of area
      • Waive own coverage if eligible for another employer plan

Additional Life/AD&D

      • No changes permitted

Health Care FSA

      • No changes permitted

Dependent Care FSA

      • No changes permitted
Court order to add coverage

Changes you can make to

Medical/Dental/Vision

      • Add children covered by order
      • Drop if court orders coverage by another person

Additional Life/AD&D

      • No changes permitted

Health Care FSA

      • Enroll or increase election as a result of new dependents

Dependent Care FSA

      • No changes permitted
Significant change to program such as premium increase or dropping or adding plans during the plan year

Changes you can make to

Medical/Dental/Vision

      • Drop spouse or dependents
      • Switch medical or dental plans
      • Waive own coverage if enrolling in another plan

Additional Life/AD&D

      • No changes permitted

Health Care FSA

      • No changes permitted

Dependent Care FSA

      • Enroll or increase election correspondingly
      • Cease election
Loss of medical coverage due to exhaustion of COBRA or state continuation period

Changes you can make to

Medical/Dental/Vision

      • Add family members losing coverage
      • Switch medical or dental plans if adding family members

Additional Life/AD&D

      • No changes permitted

Health Care FSA

      • No changes permitted

Dependent Care FSA

      • No changes permitted