Congratulations on the new addition, or expected addition, to your family! A birth, adoption, acquired legal guardianship is a qualifying life event and allows 30-days (from the date of the event) for a mid-year change or addition of benefits. Please formally notify Employee Services of the change as directed below. Contact HR to determine qualification for leave under the Family & Medical Leave Act (FMLA) Provide a copy of the birth certificate, adoption agreement, or legal paperwork to HR Complete a Life Change Event Form Make changes, or additions, to benefits within a 30-day window of the birth, adoption, or guardianship change (see below) Benefits to consider adding/updating and links to forms: Health Insurance (Add dependent, need Social Security Number) Dental Insurance (Only if not a newborn) Vision Insurance (Only if not a newborn) Aflac-Flex Spending Accounts (Medical and Dependent Care) Life Insurance Supplemental Coverage Enrollment Form ($2,000 or $5,000) Must also complete Evidence of Insurability (EOI) with Enrollment Form Update Beneficiaries (most people list dependents as contingent beneficiaries) Update Retirement Beneficiaries NDPERS Retirement Employees click here TIAA-CREF Retirement Employees update online or contact customer service at 1-800-842-2252

A spouse personally losing insurance coverage, or for dependents, is a qualifying life event and allows 30-days (from the date of the event) for mid-year change or addition of benefits. Please formally notify Employee Services of the change as directed below. Contact HR Provide an email from your spouse's employer or a Certificate of Creditable Coverage Complete a Life Change Event Form Make changes, or additions, to benefits within a 30-day window of the loss of coverage(see below) Benefits to consider adding/updating and links to forms:  **Needs updated links** Health Insurance Dental Insurance Vision Insurance Aflac-Flex Spending Accounts (Medical and Dependent Care) Life Insurance Supplemental Coverage Enrollment Form ($2,000 or $5,000) Must also complete Evidence of Insurability (EOI) with Enrollment Form Update Beneficiaries (most people list dependents as contingent beneficiaries) Update Retirement Beneficiaries NDPERS Retirement Employees click here TIAA-CREF Retirement Employees update online or contact customer service at 1-800-842-2252

A change in your childcare provider or rates is a qualifying life event and allows 30-days (from the date of the event) for mid-year change or addition of a Flex Spending Account - Dependent Care Account. Contact HR Provide a copy of the invoiced rates, notice of rate changes, or receipt Complete a Life Change Event Form Make changes to, or an addition of, a Flex Spending Account - Dependent Care Account within a 30-day window of the date of change (see below) Benefits to consider adding/updating and links to forms: ** Need updated Link ** Aflac-Flex Spending Accounts (Dependent Care Account)

Dependents may remain on insurance until the age of 26 (after July 1, 2011). If your dependent will soon reach this age please notify HR of the change. Please formally notify Employee Services of the change as directed below. Contact HR Complete a Life Change Event Form Make changes to benefits where dependent is enrolled for coverage (see below) Benefits to update and links to forms: ** Needs updated links ** Health Insurance Dental Insurance Vision Insurance Life Insurance Supplemental Coverage Enrollment Form ($2,000 or $5,000)

Occasionally positions held, or employment status within the position, will change to include eligibility for benefits. This is a qualifying life event and allows 30-days (from the date of the event) for mid-year changes or addition of benefits. Please formally notify Employee Services of the change as directed below. Contact HR Complete a Life Change Event Form Make changes, or additions, to benefits within a 30-day window of the employment status change (see below) Benefits to update and links to forms: ** Needs updated links ** Health Insurance Dental Insurance Vision Insurance Aflac-Flex Spending Accounts (Medical and Dependent Care) Life Insurance Supplemental Coverage Enrollment Form Update Beneficiaries (most people list dependents as contingent beneficiaries) Retirement Contact HR

We are very sorry for your loss. We will work with you to make this transition seamless. A loss of a loved one is a qualifying life event and allows 30-days (from the date of the event) for a mid-year change or addition of benefits. Please formally notify Employee Services of the change as directed below. Contact HR Provide a copy of the death certificate to HR Complete a Life Change Event Form Make changes, or additions, to benefits within a 30-day window of the loss (see below) Benefits to consider adding/updating and links to forms: ** Needs updated links ** Health Insurance Dental Insurance Vision Insurance Aflac-Flex Spending Accounts (Medical and Dependent Care) Life Insurance Supplemental Coverage Enrollment Form Update Beneficiaries (most people list dependents as contingent beneficiaries) Retirement Contact HR

Marital status changes include: marriage, divorce, and legal separation. We will work with you to make this transition seamless. A marital status change is a qualifying life event and allows 30-days (from the date of the event) for a mid-year change or addition of benefits. Please formally notify Employee Services of the change as directed below. Contact HR Provide a copy of the marriage license, divorce decree, or legal separation decree to HR Bring in the original, new Social Security Card to HR (if changing name) Complete a Life Change Event Form Reference name change instructions (if applicable) Make changes, or additions, to benefits within a 30-day window of the change in marital status (see below) Benefits to consider adding/updating and links to forms: ** Needs updated links ** Health Insurance Dental Insurance Vision Insurance Aflac-Flex Spending Accounts (Medical and Dependent Care) Life Insurance Supplemental Coverage Enrollment Form Update Beneficiaries (most people list dependents as contingent beneficiaries) Retirement Contact HR

Complete the Personnel Action Form for the following types of changes: Classification Change - FTE Change, Promotion, Transfer, etc. Employment Change - New Hire, Person of Interest, Rehire, etc. Payroll Change - Additional Pay, Funding Change, Pay Rate Change, etc.