Major Life Events Checklist

Outside of the annual open enrollment period, an employee may change an enrollment election (i.e., add or delete dependents, change level of coverage) only if there has been a "major life event."

The following are considered qualifying events:

• Marriage or divorce of the employee

• The employee meets the minimum requirements on the Financially Interdependent Partners Statement or ends a relationshsip with a financially interdependent partner.

• An enrolled family member dies.

• Birth or adoption of a child by the employee

• Termination of employment (or commencement of employment) of the employee’s spouse

• Taking an unpaid leave of absence by the employee or the employee’s spouse

• The employee or spouse/partner has a significant change in employment status (for example, you go from part-time to full-time or vice versea, or your spouse loses or gains employment).

• You waive medical coverage for yourself or your family members because of other health-care coverage—and you lose that other coverage for certain reasons.

Changes (addition or deletion of dependents) will be limited to those that are both on account of a major life event, and are consistent with that major life event. Enrollment changes are subject to the other terms and limitations of this program.

If you have experienced a Major Life Event, you may want to add or delete dependents, or change your level of coverage for supplemental benefit elections. You may also need to change your marital status, address, beneficiary, etc. The list of forms on this page may assist you in making these decision(s). Changes that alter your level(s) of coverage (i.e.: health insurance, life insurance, AD&D, reimbursement accounts, etc) must be received by Human Resource Services within 30 days of the major life event with the exception of adding a newborn which can be done up to 60 days after birth.


Forms of Interest

• Contact Pension or ORP vendor to update beneficiary information
• Contact TDA Vendor to update beneficiary information

TRS/PERS Beneficiary Form to update beneficiary information

Optional/Supplemental Benefits
Beneficiary Designation (change beneficiary information)
• Employee Selected Benefits/Deduction form

Supplemental Life: Increase/decrease level of supplemental life if applicable
Accidental Death and Dismemberment, elect or change coverage
Reimbursement Account: Add dependent care, or health, reimbursement account

Forms indicated above may be downloaded from this Web site or are available through your local HR office.

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