Changing Medical/Dental Enrollment
for Faculty, Staff & Librarians

• You must enroll yourself in medical insurance to add your newborn or adopted child to medical coverage.
• You must enroll yourself in medical insurance to add your newborn or adopted child and spouse/Qualified Domestic Partner in medical coverage.

Within 60 days* in advance of assuming legal obligation for the support of a child through birth or adoption, submit these forms to the Benefits Office:

• Employee Enrollment/Change Form
• Dependent Verification Documents
• When adding a Qualified Domestic Partner, submit a Declaration of Tax Status Form. (No additional form is required for legally married couples.)

• You may enroll your newborn or adopted child in medical and/or dental insurance.
• You may enroll your spouse/Qualified Domestic Partner in medical and/or dental insurance only if you also enroll your newborn or adopted child.
• You may change your medical and/or dental plan only if you are also enrolling your newborn or adopted child in the plan.
• You may waive medical insurance for yourself, and medical and/or dental insurance for your eligible dependents, only if they all have other comprehensive group medical insurance coverage.

• Within 60 days* in advance of assuming legal obligation for the support of a child through birth or adoption, submit these forms to the Benefits Office, even if adding your new child does not increase your premiums:
• Employee Enrollment/Change form - note the date of adoption or date you assumed financial responsibility of the child(ren) on this form.
• Dependent Verification Documents
• When adding a Qualified Domestic Partner, submit a Declaration of Tax Status Form. (No additional form is required for legally married couples.)

• If adding the child increases the insurance premium (i.e. you currently have no other child enrolled on your plan), the plan subscriber must submit the required enrollment form no later than 12 months after the date of birth, adoption, or the date legal obligation is assumed for the total or partial support in anticipation of adoption.
• Subscriber may not change plans or add a spouse outside the 60 day special open enrollment.
• Retroactive premiums will be due back to the date of adoption.

• New Child: For newborns, health insurance coverage begins on the date of birth. For an adopted child, insurance coverage begins on the date you assume legal obligation.
• Spouse: Health insurance coverage begins on the first day of the month in which the birth occurs or the month you assume legal obligation for a new child.
• Plan Change: New health insurance plan coverage begins the first day of the month in which the birth occurs or the month you assume legal obligation for a new child.

• Evaluate your life insurance coverage and retirement plan to make sure your beneficiary designations are current. See Beneficiary Designations.
• Evaluate the optional period of your long-term disability insurance.
• You may enroll, change, or cancel your participation in these optional tax-savings programs:
  • Flexible Spending Account
  • Dependent Care Assistance Program