* Only allows removal of spouse from health and dental coverage.

Health Insurance
  • You must remove your former spouse and former spouse’s eligible family members from coverage. 
  • You cannot remove other dependents from coverage unless they are added to your former spouse’s plan. 
  • You may enroll yourself in coverage and add dependents if the event causes loss of coverage under former spouse’s plan.
  • You may change your health plan if you are adding dependents that lost coverage under your former spouse’s plan.

Dental Insurance
  • You must remove your former spouse and former spouse’s eligible family members from coverage.
  • You cannot remove other dependents from coverage unless they are added to your former spouse’s plan.  
  • You may enroll yourself in coverage and add dependents if the event causes loss of coverage under former spouse’s plan.

Health FSA
  • You may decrease your contribution to reflect loss of your spouse’s eligibility. 
  • You may enroll or increase your contribution if coverage is lost under your spouse’s health or health FSA plan. 

Dependent Care FSA
  • You may enroll or increase contributions if event increases dependent care expenses or causes loss of coverage under spouse’s plan.
  • You may decrease contributions if event decreases dependent care expenses.

Supplemental Life Insurance
  • 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 06/2019