Dependent Spouse and/or Child Loses Insurance
Certain qualifying events allow you to make changes in benefits that otherwise are not possible until the annual Open Enrollment period. This summary outlines the benefit plan changes you may need to make as a result of your dependent spouse and/or child losing insurance coverage. Please be sure to make your changes by completing and submitting the appropriate change form and documentation to the Office of Human Resources within 31 days of the date the insurance coverage is canceled. If you do not notify Human Resources within 31 days of the event, you will need to wait until the next Open Enrollment period to make your changes.
Required Forms and Documentation
- Medical/Dental/Vision Insurance and Beneficiary Change Application (PDF)
- Letter from Employer stating the Termination Date of Benefits
- One of the following:
- Government issued Marriage Certificate (if married within last 12 months) – Copy OR
- Government issued Marriage Certificate and pg. 1 of Federal Tax Return within last two years – Copy
- Government issued Birth Certificate(s) – Copy (if adding dependent children)
- Life Insurance Evidence of Insurability (PDF)
Medical/Prescription Drug, Dental and Vision
If you are currently enrolled in a University medical, dental and/or vision plan and a family member loses his/her insurance coverage, you may wish to add your dependent spouse and/or children to your University plan.
If you are not currently enrolled in a University health plan, you may elect coverage for yourself along with your dependent spouse and/or children.
In both instances, you will need to provide a letter from your spouse/child’s employer stating the date his/her insurance coverage was terminated along with the appropriate dependent verification documentation.
Coverage will be effective as of the date of coverage loss through your spouse/child’s employer.
This is a good time to reevaluate your life insurance coverage and determine whether you would like dependent life insurance for your spouse. You may also choose to update or change your life insurance beneficiary(ies). This change may require that you complete an Evidence of Insurability form.
Flexible Spending Accounts (FSAs)
You may wish to reevaluate your participation in Health Care and Dependent Care Flexible Spending Accounts by signing up now or, if already participating, changing your contribution amount. You may need to increase your Health Care FSA contributions to pay for your spouse and/or child(ren)’s out-of-pocket health care expenses and/or begin, stop, increase, or decrease contributions to a Dependent Care FSA.
This is a good time to review your retirement programs, investment elections, and contribution amounts to make sure they reflect your new financial goals. You may wish to update or change your beneficiary(ies) as well.
- How do I make my Open Enrollment benefit elections for 2015?
- Where can I get a health screening and how do I access Your HRQ (Health Risk Questionnaire)?
- How do I schedule a confidential one-on-one consultation with a Fidelity Planning and Guidance Consultant?
- How do I get a copy of my (Medical / Dental / Vision) ID card?
- What are the dates for paid holiday time in 2014?