Page 5 - Future Steps
P. 5
2017 BENEFITS ENROLLMENT
What Will You Need To Enroll, Make
Changes, and/or Verify Spouse Eligibility?
When it is time to enroll, you will need to have the following items on
hand.
This booklet as a reference
The names, Social Security numbers, and dates of birth and addresses
of any/all dependents you may wish to enroll in one or more of the
plans if they are not already enrolled
Life Insurance beneiciary information—name, Social Security
number, date of birth, address, and phone number
If you are adding or dropping any dependents, documentation is
required and may include items such as a marriage certiicate; birth
certiicate(s); certiicate of adoption; proof of legal guardianship;
certiied copy of a qualiied medical child support orders, and
certiicate of children of any age who depend on you for inancial
support because of a physical/mental disability, which was established
prior to age 18 or while as an eligible dependent
It is always advisable to review your beneit choices and check to
assure you have beneiciaries listed
If you are not making any changes to your current elections
and do not have your spouse enrolled in the medical plan, then
you do not need to contact the call center during this open
enrollment; all of your current elections will roll over into the
new 2017 plan year
REGIONAL ONE HEALTH 5
What Will You Need To Enroll, Make
Changes, and/or Verify Spouse Eligibility?
When it is time to enroll, you will need to have the following items on
hand.
This booklet as a reference
The names, Social Security numbers, and dates of birth and addresses
of any/all dependents you may wish to enroll in one or more of the
plans if they are not already enrolled
Life Insurance beneiciary information—name, Social Security
number, date of birth, address, and phone number
If you are adding or dropping any dependents, documentation is
required and may include items such as a marriage certiicate; birth
certiicate(s); certiicate of adoption; proof of legal guardianship;
certiied copy of a qualiied medical child support orders, and
certiicate of children of any age who depend on you for inancial
support because of a physical/mental disability, which was established
prior to age 18 or while as an eligible dependent
It is always advisable to review your beneit choices and check to
assure you have beneiciaries listed
If you are not making any changes to your current elections
and do not have your spouse enrolled in the medical plan, then
you do not need to contact the call center during this open
enrollment; all of your current elections will roll over into the
new 2017 plan year
REGIONAL ONE HEALTH 5
