Page 3 - Benefit Guide
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YOUR [20XX] BENEFITS GUIDE


Welcome to 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
Annual Enrollment spouse and children up to age 26.

Annual enrollment is your yearly opportunity to review your current Some age limitations may apply
beneits and make beneit changes for the upcoming plan year. During to certain insurance programs.
annual enrollment, you can add, change, or decline coverage. In addition, Please review your plan documents
you can add and/or drop dependents during this time. carefully for more details. Children
may include natural, adopted,
Qualifying Life Event step-children, or children obtained

Once you make your elections, you will not be able to make changes until through court-appointed legal
guardianship.
the next annual enrollment period unless you experience a qualifying life
event. A qualifying life event is a change in your personal life which may Eligibility Documentation
impact your eligibility or dependent’s eligibility for beneits. Examples of
some qualifying events include the following. Please be prepared to share
dependent eligibility information
z Change of legal marital status (e.g., marriage, divorce, death of during enrollment including each
spouse, legal separation) enrolled dependent’s date of birth

z Change in number of dependents (e.g., birth, adoption, death of and Social Security Number. Other
dependent, ineligibility due to age) documentation may be required

z Change in employment or job status depending on your beneit
elections.


















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