Page 3 - 2020-21 Sample Benefits Guide
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[Company Name] Benefits Enrollment Guide
Your [20XX] Benefits Guide
At [Company Name], we offer a competitive and comprehensive beneits program to recognize how important you
are to the company. This beneits guide summarizes our program in a quick and easy-to-understand way. Please
review your plan documents for more details.
New Hire Enrollment Benefits Eligibility
Welcome to our team! As a new employee, you are Covering Yourself
eligible for coverage on your [XX] day of employment. You may enroll in the beneits program if you are a
You must enroll in beneits within [XX] days of your regular full-time employee who is actively working a
date of hire. minimum of 30 hours per week.
Annual Enrollment Covering Your Family Members
Annual enrollment is your yearly opportunity to Eligible dependents generally include your legally
review your current beneits and make changes for the married spouse and children up to age 26. Some age
upcoming plan year. During annual enrollment, you can limitations may apply to speciic insurance programs.
add, change, or decline coverage. You can also add and/ Children may include natural, adopted, step-children,
or drop family members for coverage during this time. or children obtained through court-appointed legal
This year’s annual enrollment will take place [Month guardianship.
XX–XX, 20XX].
Eligibility Documentation
Changing Your Benefits Mid-Year Please be prepared to share dependent eligibility
Once you make your elections, you will not be able to information during enrollment including date of birth
make changes until next year’s annual enrollment unless and Social Security Numbers. Other documentation
you experience a qualifying life event. Examples of may be required depending on your elections.
qualifying events include the following.
Change of legal marital status (e.g., marriage,
divorce, death of spouse, legal separation)
Change in number of dependents (e.g., birth,
adoption, death of dependent, ineligibility due to
age)
Change in employment or job status
You must make changes to your beneits within [30/31]
days of your qualifying life event. If you do not make
changes during this time, you may have to wait until
next year’s annual enrollment to make your change.
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Your [20XX] Benefits Guide
At [Company Name], we offer a competitive and comprehensive beneits program to recognize how important you
are to the company. This beneits guide summarizes our program in a quick and easy-to-understand way. Please
review your plan documents for more details.
New Hire Enrollment Benefits Eligibility
Welcome to our team! As a new employee, you are Covering Yourself
eligible for coverage on your [XX] day of employment. You may enroll in the beneits program if you are a
You must enroll in beneits within [XX] days of your regular full-time employee who is actively working a
date of hire. minimum of 30 hours per week.
Annual Enrollment Covering Your Family Members
Annual enrollment is your yearly opportunity to Eligible dependents generally include your legally
review your current beneits and make changes for the married spouse and children up to age 26. Some age
upcoming plan year. During annual enrollment, you can limitations may apply to speciic insurance programs.
add, change, or decline coverage. You can also add and/ Children may include natural, adopted, step-children,
or drop family members for coverage during this time. or children obtained through court-appointed legal
This year’s annual enrollment will take place [Month guardianship.
XX–XX, 20XX].
Eligibility Documentation
Changing Your Benefits Mid-Year Please be prepared to share dependent eligibility
Once you make your elections, you will not be able to information during enrollment including date of birth
make changes until next year’s annual enrollment unless and Social Security Numbers. Other documentation
you experience a qualifying life event. Examples of may be required depending on your elections.
qualifying events include the following.
Change of legal marital status (e.g., marriage,
divorce, death of spouse, legal separation)
Change in number of dependents (e.g., birth,
adoption, death of dependent, ineligibility due to
age)
Change in employment or job status
You must make changes to your beneits within [30/31]
days of your qualifying life event. If you do not make
changes during this time, you may have to wait until
next year’s annual enrollment to make your change.
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