Page 3 - United Capital EE Guide 04-17

ENROLLMENT INFORMATION

WHO MAY ENROLL
If you are a regular, full-time employee working at least 30 hours per week, you and your eligible dependents may participate in
United Capital’s benefits program. Your eligible dependents include:
z Legally married spouse
z Registered domestic partner
z Children under the age of 26, regardless of student or marital status

WHEN YOU MAY ENROLL
As an eligible employee, you may enroll at the following times:
z As a new hire, you may participate in the company’s benefits program on the first day of the month following your date of hire
z Each year, during open enrollment
z Within 30 days of a qualifying event as defined by the IRS (see Changes To Enrollment)
z You may enroll in Voluntary Short Term Disability, Voluntary Long Term Disability, and Voluntary Accident Insurance at any time
z You may enroll in Voluntary Life/AD&D, Voluntary Critical Illness, and GAP Insurance at any time, subject to proof of good
health and carrier approval

PAYING FOR YOUR COVERAGE
The Basic Life/AD&D benefits are provided at no cost to you and are paid entirely by United Capital. You and the company share
in the cost of the Medical benefits you elect. Any Dental, Vision, Voluntary Life/AD&D, Voluntary Short Term Disability, Long Term
Disability, and Supplemental (Voluntary Accident, Voluntary Critical Illness, and Gap Insurance) benefits you elect will be paid by you
at discounted group rates. Your Medical, Dental, and Vision contributions are deducted before taxes are withheld which saves you
tax dollars. Paying for benefits before-tax means that your share of the costs are deducted before taxes are determined, resulting in
more take-home pay for you. As a result, the IRS requires that your elections remain in effect for the entire year. You cannot drop
or change coverage unless you experience a qualifying event.

CHANGES TO ENROLLMENT
Our benefit plans are effective April 1st through March 31st of each year. There is an annual open enrollment period each year,
during which you can make new benefit elections for the following April 1st effective date. Once you make your benefit elections,
you cannot change them during the year unless you experience a qualifying event as defined by the IRS. Examples include, but are
not limited to the following:
z Marriage, divorce, legal separation or annulment
z Birth or adoption of a child
z A qualified medical child support order
z Death of a spouse or child
z A change in your dependent’s eligibility status
z Loss of coverage from another health plan
z Change in your residence or workplace (if your benefit options change)
z Loss of coverage through Medicaid or Children’s Health Insurance Program (CHIP)
z Becoming eligible for a state’s premium assistance program under Medicaid or CHIP

Please note that coverage for a new dependent is not automatic. If you experience a qualifying event, you have 30 days to update
your coverage. You may login to Ultimate to update your dependent information as needed. If you do not update your coverage
within 30 days from the qualifying event, you must wait until the next annual open enrollment period to update your coverage.

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