Page 4 - 2016 Enrollment
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Life Changes




Making Changes (Qualifying Life Events)


The Internal Revenue Service (IRS) regulations provide that eligible
employees may only make elections to the plan once a year unless
you experience a qualiied life status change. If no qualifying event
occurs, your 2016 open enrollment beneit choices are binding through
December 31.


The following special circumstances are the ONLY reasons you may
change your beneits during the year:

„ Marriage

„ Divorce or legal separation

„ Birth, adoption, or placement of a child for adoption

„ Termination or commencement of your spouse’s coverage in general
when coverage is maintained through the spouse’s plan

„ Shift from part-time to full-time status (or vice versa) by you or your
spouse

„ Death of spouse or dependent

„ When a dependent satisies or ceases to satisfy eligibility requirements
„ Taking an unpaid leave of absence (you or your spouse)

„ A residence or worksite change that impacts healthcare coverage

These special circumstances, often referred to as life event changes, will
allow you to make plan changes at the time during the year in which
the life event occurs. For any allowable changes, you must inform

Human Resources within 31 calendar days of the event to avoid a lapse
in coverage. If you do not notify Human Resources of the event and
provide requested documentation within 31 calendar days of the event,
you will not be eligible to make changes until the next annual open
enrollment period.


Changes that are requested due to a “change of mind” cannot be allowed until the next
open enrollment period.




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