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Your [20XX] Benefits Guide
Welcome to 20XX Benefits Enrollment Benefits Eligibility
At [Company Name], we offer our employees a competitive and Eligible Employees
comprehensive beneits program. This is one of many ways we recognize
how important you are to the company. This beneits guide briely You may enroll in the beneits
summarizes our program in a quick and easy-to-understand way. program if you are a regular full-
time employee who is actively
New Hire Enrollment working a minimum of [XX]
hours per week.
Welcome to our team! As a new employee, you are eligible for coverage
on your [XX] day of employment. However, you must enroll in beneits Eligible Dependents
within [XX] days of your date of hire. Eligible dependents generally
include your legally married
Open Enrollment spouse and children up to age
Open enrollment is your annual opportunity to review your current 26. Children may include natural,
beneits and make beneit changes for the upcoming plan year. During adopted, step-children, or children
open enrollment, you can add, change, or decline coverage. In addition, obtained through court-appointed
you can add and/or drop dependents during this time. legal guardianship.
Qualifying Life Event SSN Required
Once you make your elections, you will not be able to make changes until You must provide a valid Social
the next annual enrollment period unless you experience a qualifying life Security Number for yourself
event. A qualifying life event is a change in your personal life that may and each enrolled dependent.
impact your eligibility or dependent’s eligibility for beneits. Examples of Employers are required to
some qualifying events include the following. provide names and Social
Security Numbers to the federal
Change of legal marital status (e.g., marriage, divorce, death of government for each individual
spouse, legal separation) enrolled for medical coverage.
Change in number of dependents (e.g., birth, adoption, death of
dependent, ineligibility due to age)
Change in employment or job status
[Client Name] 3
Welcome to 20XX Benefits Enrollment Benefits Eligibility
At [Company Name], we offer our employees a competitive and Eligible Employees
comprehensive beneits program. This is one of many ways we recognize
how important you are to the company. This beneits guide briely You may enroll in the beneits
summarizes our program in a quick and easy-to-understand way. program if you are a regular full-
time employee who is actively
New Hire Enrollment working a minimum of [XX]
hours per week.
Welcome to our team! As a new employee, you are eligible for coverage
on your [XX] day of employment. However, you must enroll in beneits Eligible Dependents
within [XX] days of your date of hire. Eligible dependents generally
include your legally married
Open Enrollment spouse and children up to age
Open enrollment is your annual opportunity to review your current 26. Children may include natural,
beneits and make beneit changes for the upcoming plan year. During adopted, step-children, or children
open enrollment, you can add, change, or decline coverage. In addition, obtained through court-appointed
you can add and/or drop dependents during this time. legal guardianship.
Qualifying Life Event SSN Required
Once you make your elections, you will not be able to make changes until You must provide a valid Social
the next annual enrollment period unless you experience a qualifying life Security Number for yourself
event. A qualifying life event is a change in your personal life that may and each enrolled dependent.
impact your eligibility or dependent’s eligibility for beneits. Examples of Employers are required to
some qualifying events include the following. provide names and Social
Security Numbers to the federal
Change of legal marital status (e.g., marriage, divorce, death of government for each individual
spouse, legal separation) enrolled for medical coverage.
Change in number of dependents (e.g., birth, adoption, death of
dependent, ineligibility due to age)
Change in employment or job status
[Client Name] 3
