Instructions on how to complete Enrollment/Change for: I divorced my spouse

Transcription

1 Instructions on how to complete Enrollment/Change for: I divorced my spouse 1. Log into the enrollment site at: Employee ID or SSN PIN: Last 4 of SSN and last 2 of birth year Ex

2 2. Please read all information to help with your Enrollment/Change. 3. Click Next

3 4. Under the heading: You & Your Family, choose Life Events

4 5. Choose: I divorced my spouse 6. Click Next

5 7. Please enter the actual divorce date and check the box next to spouse and any other dependents you wish to drop due to divorce. If your name or address has changed, please update with your department human resource staff as soon as possible. If you have new dependent children as a result of divorce check that box. 8. If no additional dependent children to add, click next to continue

6 9. If you do not have dependent child(ren) to add as a result of divorce proceed to #??? now. Click the + plus sign to add dependent child(ren). If you have more than one dependent child you will click the + sign to add each child separately.

7 10. Add Reason, Relationship, Event Date (Date of Marriage), Name, Date of Birth, SSN, and Gender. 11. Click Save to Continue

8 12. Once all new dependents have been added, click Next to continue.

9 13. Enter your PIN (Last 4 of SSN and last 2 of birth year) and click the orange check box to continue.

10 14. It will bring up all benefit plans you are eligible to make changes to (if you would like) due to your life event. Please check all plans you wish to make changes to. If you do not wish to make any changes to any flexible benefit plans and/or voluntary plans do not select. You must drop spouse (and dependent child(ren) from your medical, dental and prescription drug plans for benefit coverage. 12. Click Next to continue

11 13. Dependent Verification- You will see what you entered in your last session. To drop your spouse (and dependent child(ren) click the circle next to Yes and add the name of your spouse (and dependent child(ren), divorce date and current address of spouse (and dependent child(ren) in the box under your name. Click Next to continue.

12 14. It will take you to the first benefit box you checked. You should verify your ex-spouse (and dependent child(ren) is not listed under Covered People and not enrolled under your current medical plan. If you were previously: Employee + Family and you no longer have any dependents, you will now need to select Employee Only. You and all eligible dependents should be shown under Covered People. If correct, click the Enroll button. Please note: you may not change medical plans.

13 15. Frontpath enrollee s please proceed to #17 If enrolled in either Paramount Plans verify you all eligible dependent s PCP ID NUMBER and PCP NAME are correct. If you need to update, click FIND, next to Look up PCP. You may also log onto the Paramount website at or contacting Paramount Member Services at to update as well. 16. Click Next to continue

14 17. OTHER PRIMARY INSURANCE: Spouse/Dependent Medical and Vision Insurance. Please review all eligible depent s other primary coverage. If dependent child(ren) have no other primary coverage, please write n/a. 18. Click Next to continue

15 19. Review Medical and Vision Plan and all covered dependents. If correct, please click Confirm.

16 20. Now you will need to click the Review button of another benefit plan you indicated you would like to make changes to. For example: Click Review next to Dental to add new dependent to your current Dental plan.

17 21. You should verify your new ex-spouse (and dependent child(ren) is not listed under Covered People and enrolled under your current dental plan. Once confirmed, click the Enroll button. You may not change dental plans.

18 22. OTHER PRIMARY INSURANCE: Spouse/Dependent Dental Insurance. Review other primary dental coverage please listed here. If no other primary coverage, please write n/a. 23. Click Next to continue

19 24. Review Dental Plan and all covered dependents. If correct, please click Confirm.

20 25. Now you will need to click the Review next to Prescription Drug Plan to drop spouse (and dependent child(ren) from your Prescription Drug plan.

21 26. Verify your ex-spouse (and dependent child(ren) is not listed under Covered People and not enrolled under your prescription drug plan. Once confirmed, click the Enroll button.

22 27. OTHER PRIMARY INSURANCE: Spouse/Dependent Prescription Drug Insurance. Review other primary prescription drug coverage for any eligible dependent s listed here. If no other primary coverage, please write n/a. 28. Click Next to continue

23 29. Review Prescription Drug Plan and all covered dependents. If correct, please click Confirm.

24 30. Click the Review button of another benefit plan you indicated you would like to make changes to. Click Review next to Basic Life & AD&D to make any beneficiary changes to your life insurance plan.

25 31. Click Next if you would like to continue your Basic Life & AD& D insurance and make changes to your beneficiaries.

26 32. Make changes to your beneficiaries. You can make changes to currently listed beneficiaries as a Primary or Contingent beneficiary. (If you would like to add any other beneficiaries not listed click the + sign). 33. Click Next to continue

27 34. Review your Basic Life & AD&D plan and beneficiaries. If correct, please click Confirm.

28 35. Continue to click all other benefit plans (MEDFSA, Dependent Care, Voluntary Insurance Plans) you opened to make changes to and confirm all changes. 36. Once you have completed all changes, it will take you to the Sign and Submit Page. Please review all your elections and click Next.

29 37. Review your Benefit Confirmation Form and Sign. Your electronic signature is your PIN. (Last 4 of SSN and last 2 of birth year)

30 38. Review Social Security Identification Number Consent Form and Sign. Your electronic signature is your PIN. (Last 4 of SSN and last 2 of birth year)

31 39. Once you have signed both forms you will see Sign/Submit Complete and Congratulations letting you know your enrollment is finished. You will also receive your benefit confirmation form ed to the provided for your records. 40. Documentation will need to be submitted to Employee Benefits in order for your enrollment/change to be processed. All documentation can be ed to inter-office to Employee Benefits or faxed to If you have any questions or would like assistance with processing your Enrollment/Change please call Strategic Enrollment Services (SES) at or Employee Benefits at