(You must complete the Domestic Partnership: Cancellation of Health and Dental Coverage form. Contact your Human Resources Associate for assistance in making the change.)
| Health Insurance |
- You may only cancel coverage for dependent that is no longer eligible.
|
| Dental Insurance |
- You may only cancel coverage for dependent that is no longer eligible.
|
| Health FSA |
- You may decrease or cancel contribution.
|
| Dependent Care FSA |
- You may decrease or cease the election if the dependent reaches the age of 13 or becomes capable of self-care, if the domestic partner and dependent are tax dependents.
|
| Supplemental Life Insurance |
- If the Domestic Partner's dependent is the employee's tax dependent, you may enroll or increase the amount of your coverage. Satisfactory evidence of insurability is required.
- You may cancel or decrease the amount of your coverage.
|
Updated 10/2019
