Page 5 - TriStar Energy-2023-Benefit Guide-V26(WLP)-LRI

Eligibility

Who’s eligible?
Team Members You must notify Benefits within 30 days from the
Full-time team members who work at least 30 hours per qualified life event to make changes to your coverage.
week are eligible for the benefits described in this guide. • Depending on the type of event, you may need to
Your open enrollment benefits are effective January 1, 2023, provide proof of the event, such as a marriage license.
or on the first of the month following 30 days of • If you do not notify Human Resources within 30 days of
employment, whichever is later. After 12 months of the qualified event, you will have to wait until the next
full-time employment, you qualify for company paid open enrollment period to make changes (unless you
Long-Term Disability. experience another qualified life event).

Dependents
• Your legal spouse (spouses eligible for group medical Enrolling dependents? Items to have ready
benefits through their employer, are not eligible for When you add dependents to your coverage, you
coverage with Tri Star) must provide the following information:
• Your children up to age 26 • Legal name

Making changes to your benefits • Date of birth
Generally, you may only make or change your existing • Social Security number
benefit elections as a new hire or during the annual • Supporting documentation, such as marriage
open enrollment period. However, you may change your certificate, birth certificate, adoption papers,
benefit elections during the year if you experience an and tax documents
event such as: If you do not provide the required information,
• Marriage your dependents may be dropped from coverage
• Divorce or legal separation
• Birth of your child or your domestic partner’s child
• Death of your spouse, domestic partner or Benefit Plan Notices
dependent child Benefit Plan Notices are located in the back of this
• Adoption of or placement for adoption of your child guide. A printed copy of any notice is available
• Loss or gain of other coverage by you or your dependent by contacting Benefits via email at benefits@
• Eligibility for Medicare or Medicaid tristarenergy.com or by calling 615-313-3600.
• Change in employment status of Team Member, spouse/
domestic partner or dependent child
• Qualification by the Plan Administrator of a child support
order for medical coverage
• New entitlement to Medicare or Medicaid

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