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Update Dependents

If you experience a life-changing event, you may need to change your current health-plan enrollment status or update your dependents.


What Qualifies as a Life-Changing Event?

  • Marriage
  • Legal separation or divorce
  • Birth or adoption
  • Losing or gaining health coverage for yourself or dependents
  • Death of an eligible dependent

When Do Benefit Changes Become Effective When Reporting a Life-Changing Event?

When Life-Changing Event is Reported

When Benefit Changes are Effective
Within 30 days of event
Date of life event
 After 30 days and no later than 90 days of the event The first of the following month
 After 90 days of the event Must wait until the next Open Enrollment

How to Change Coverage or Dependent Information

Submit the following form and supporting documentation

When submitting the forms, be sure to include your full name and retiree ID number. Without this information, Employee Benefits will not be able to process your request. Send form and documents to