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10000050018
Adoption, Birth or Legal Guardianship
Congratulations on the new addition, or expected addition, to your family! A birth, adoption, acquir
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10000050036
Change/Loss Spouse Insurance
A spouse personally losing insurance coverage, or for dependents, is a qualifying life event and all
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10000050037
Childcare Change
A change in your childcare provider or rates is a qualifying life event and allows 30-days (from the
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10000050038
Dependent Losing Status
Dependents may remain on insurance until the age of 26 (after July 1, 2011). If your dependent will
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10000050039
Employment Status Change
Occasionally positions held, or employment status within the position, will change to include eligib
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10000050040
Loss of Loved One
We are very sorry for your loss. We will work with you to make this transition seamless. A loss of a
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10000050041
Marital Status Change
Marital status changes include: marriage, divorce, and legal separation. We will work with you to ma
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10000050043
Position Changes
Complete the Personnel Action Form for the following types of changes:
Classification Change - F