Page 3 - Benefits Guide
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At [Company Name], we offer our employees a competitive and Benefits Eligibility
comprehensive beneits program to recognize how important you are
to the company. This beneits guide summarizes our program in a quick Covering Yourself
and easy-to-understand way. Please review your plan documents for more You may enroll in the beneits
details. program if you are a regular full-
time employee who is actively
New Hire Enrollment working a minimum of [XX]

Welcome to our team! As a new employee, you are eligible for coverage hours per week.
on your [XX] day of employment. However, you must enroll in beneits
within [XX] days of your date of hire. Covering Your Family

Annual Enrollment Eligible dependents generally

Annual enrollment is your yearly opportunity to review your current include your legally married
spouse and children up to age 26.
beneits and make beneit changes for the upcoming plan year. During Some age limitations may apply
annual enrollment, you can add, change, or decline coverage. In addition, to certain insurance programs.
you can add and/or drop dependents during this time. This year’s annual Children may include natural,
enrollment will take place [Month XX–XX, 20XX]. adopted, step-children, or children
obtained through court-appointed
Changing Your Benefits Mid-Year legal guardianship.

Once you make your elections, you will not be able to make changes until
next year’s annual enrollment unless you experience a qualifying life event. Eligibility Documentation
Examples of qualifying events include the following. Please be prepared to share

z Change of legal marital status (e.g., marriage, divorce, death of dependent eligibility information
spouse, legal separation) during enrollment including
date of birth and Social Security
z Change in number of dependents (e.g., birth, adoption, death of Number. Other documentation
dependent, ineligibility due to age) may be required depending on

z Change in employment or job status your beneit elections.
Please note, you must make changes to your beneits within [30/31] days
of your qualifying event. If you do not make changes during this time,
you may have to wait until next year’s annual enrollment to make your

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