Changing Medical/Dental Enrollment
for Faculty, Staff & Librarians
Special Open Enrollment - Loss of Other Comprehensive Group Coverage
When subscriber or dependent loses other comprehensive group coverage
| Options |
Actions |
| If you previously waived medical coverage, you must: |
-
Enroll yourself in medical.
- Enroll yourself in medical to add eligible dependent(s) in medical and/or dental.
|
Within 60 days of the loss of coverage submit these forms and supporting document to the Benefits Office:
- Employee Enrollment/Change Form
- Any necessary certification forms
- Supporting Document:
Proof of loss statement from the insurance coverage or a letter from previous employer indicating date of loss and family members that were covered.
- In addition, you may enroll, change, or cancel your participation in either of these tax-savings programs. Enrollment is optional.
|
| If you are already enrolled, you can: |
- Enroll your eligible dependent(s) in medical and/or dental.
- Change your medical and/or dental plan provided you enroll your eligible dependent.
|
Within 60 days of the loss of coverage submit these forms and supporting document to the Benefits Office:
- Employee Enrollment/Change Form
- Any necessary certification forms.
- Supporting Document:
Proof of loss statement from the insurance coverage or a letter from previous employer indicating date of loss and family members that were covered.
- In addition, you may enroll, change, or cancel your participation in either of these tax-savings programs. Enrollment is optional.
|
| Coverage Begins |
- Coverage and/or plan change begins on the first day of the month following the loss of coverage.
|
More information:
Flexible Spending Account
Dependent Care Assistance Program
Loss of Insurance Eligibility
|
Disclaimer: This "qualifying life event series" highlights benefit options arising from a change in family status. It does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority.
Changing Enrollment—
Qualifying Life Events
