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Eligibility and Enrollment 1

Eligibility

Employees who work a minimum of 30 hours per week are eligible for coverage. Your coverage is
effective on date of hire. Temporary employees and interns are not eligible for coverage under ABC
Company’s benefit plans.
Dependent Eligibility
You may choose to enroll your eligible dependents which include:

• Your spouse/domestic partner
• Your child(ren) up to age 26 (includes natural children, legally adopted children, stepchildren and your
domestic partner’s children)
• Any dependent child who is incapable of self-support because of a mental or physical disability

Enrollment

If you do not enroll within 30 days of your eligibility date, you will not be able to enroll or make mid-year
changes for any reason other than those listed in the Changing Your Elections section.

Changing Your Elections

Federal law limits when employees can change their benefit elections during the year. You may only
change your benefits during the plan year if you experience a qualifying event. Listed below are some
examples of qualifying events. Contact Human Resources if you are unsure if an event will qualify.

• Marriage, divorce, legal separation
• Birth, adoption
• Your spouse/child gains or loses health coverage
If you have a qualifying event, you must submit the election change request in PlanSource within 30
days of the event. Most changes will become effective on the first of the month following the date of the
qualifying event.