Page 3 - Benefits Guide
P. 3
Enrollment and Eligibility Examples of some qualifying events


include the following .
Enrollment
„ Change of legal marital status
Your beneits are effective on the irst of the month following 30 days (e .g ., marriage, divorce, death
of employment. You must enroll for coverage for yourself and eligible of spouse, legal separation)
dependents during your irst 15 days of employment. „ Change in number of

dependents (e .g ., birth,
If you do not enroll by the above stated enrollment deadline, you will only adoption, death of dependent,
be enrolled in company-provided beneits (basic life/AD&D, long term ineligibility due to age)
disability, and EAP coverage) and will not be permitted to elect beneits „ Change in your dependent’s

until the next open enrollment period with beneits effective May 1, employment or job status
unless you have a qualifying event as noted below.


If you do not elect the voluntary employee or spouse life and AD&D
coverage or voluntary STD coverage when initially eligible and decide
to elect at a later time, you will be required to complete an evidence of
insurability (EOI) form and be approved by Principal as described later in
the guide.


Online Enrollment

When ready, you will enroll online through ADP. When you log on, you
will be able to view any applicable current elections, change your elections,
add or remove a dependent, and change a beneiciary, if needed. You can

also ind links to additional information regarding your beneit package.

1. Log in to ADP

2. Select “Myself,” “Beneits,” “Enrollments,” “2017 Open Enrollment,”
or “New Hire Enrollment”
3. Make all of your elections and save a conirmation page


Changing Your Coverage

Once you make your elections for enrollment you will not be able to
make changes to your elections until the next annual enrollment, unless
you experience a qualifying event. A qualifying event is a change in your
personal life which may impact your eligibility or dependent’s eligibility for
beneits. Your request for change must be made in ADP and be within 30

days of the event and will be effective on the date of the event.



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