Page 3 - CW Driver Benefit Guide 2019 MAIN

ENROLLMENT INFORMATION

Who May Enroll
All regular full-time employees working at least 30 hours per week and their eligible dependents may participate in C.W.
Driver’s benefits program. Your eligible dependents include:
Legally-married spouse A copy of the marriage certificate AND one of the following documents is required:
• Front page of the most recent federal or state tax return confirming the
dependent as your spouse, OR
• A copy of a document dated within the last 60 days showing current
relationship status, such as a recurring household bill or a joint statement
of account.

The document must list employee’s name, the name of spouse, and address.
In the situation of spouses who keep their finances separate, employees may
provide separate household bills or account statements, as long as they show
the same address and are not older than 60 calendar days.
“Registered” domestic partner (same A copy of the Declaration of Domestic Partnership registered with the California
sex or opposite if over age 62) Secretary of State AND one of the following documents:
• A copy of the front page of the most recent federal or state tax return
confirming the dependent as your domestic partner, OR
• A copy of a document dated within the last 60 days showing current
relationship status, such as a recurring household bill or joint statement of
account.

The document must list employee’s name, the name of partner, and address. In
the situation of registered domestic partners who keep their finances separate,
employees may provide separate household bills or account statements, as long
as they show the same address and are not older than 60 calendar days. You
can submit one copy of your tax return if it includes all family members that
require verification.
Dependent children under age 26 One of the following documents is required:
(Medical) • A copy of the child’s birth certificate or adoption certificate naming the
Unmarried children under age 19, if not employee, spouse, or domestic partner as the parent of the child, OR
full-time students (Dental, Vision) • A copy of the court order naming the employee, spouse, or domestic partner
as the legal guardian of the child.
Unmarried children through age 24,
if they are full-time students (Dental, For a stepchild or domestic partner’s child, the employee must also provide
Vision)
documentation demonstrating the relationship to the employee’s spouse or
domestic partner, as requested above. You can submit one copy of your tax
return if it includes all family members that require verification.

When You May Enroll
Eligible employees may enroll at the following times:
• During open enrollment.
• As a new hire, you may participate in the company’s Medical, Dental, Vision, EAP, Life, AD&D, and Flexible Spending
Accounts on the first day of the month following the completion of 30 days of full-time employment.
• Within 31 days of a qualified change in family status/qualifying event (see Changes To Enrollment below).

Paying for Your Coverage
The Medical, Dental, Vision, EAP, Basic Life and AD&D benefits are provided at no cost to you and are paid entirely by C.W. Driver.
Any Voluntary Life and AD&D, and Voluntary Benefits you elect through Unum will be paid by you at discounted group rates.

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