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I am eligible for Full Benefits
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Benefits
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What You Can Do
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How to Do it
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Medical
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Enroll your family member(s) in your plan or change plans. If you are not enrolled, you can enroll yourself and your family members in a medical plan.
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Use form UPAY 850 [PDF] . You many need to choose a doctor before you enroll. See Find a Doctor if you need assistance.
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Dental
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Enroll your family member(s) in your plan.
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Use form UPAY 850 [PDF].
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Vision
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Enroll your family member(s) in the vision plan.
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Use form UPAY 850 [PDF].
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Dependent Life
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Enroll your family member(s) in Basic Dependent Life or, provided you are enrolled in Supplemental Life, Expanded Dependent Life.
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Use form UPAY 850 [PDF].
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AD&D
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Enroll your family member(s) in AD&D at any time.
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Use form UPAY 850 [PDF].
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Legal ARAG
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Enroll your family member(s), if you are enrolled.
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Use form UPAY 850 [PDF].
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Health FSA, DepCare FSA
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Enroll, de-enroll, or change your contribution (depending on the type of family changes you have) without penalty during your PIE.
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Use form UPAY 850 [PDF].
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I am eligible for Mid-level Benefits
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Benefits
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What You Can Do
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How to Do it
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Medical
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Enroll your family member in your plan or change plans. If you are not enrolled, you can enroll yourself and your family members in a medical plan.
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Use form UPAY 850 [PDF]. You many need to choose a doctor before you enroll. See Find a Doctor if you need assistance.
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Dependent Life
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Enroll your family member in Basic Dependent Life or, provided you are enrolled in Supplemental Life, Expanded Dependent Life.
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Use form UPAY 850 [PDF].
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AD&D
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Enroll your family member in AD&D at any time.
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Use form UPAY 850 [PDF].
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Legal ARAG
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Enroll your family member, if you are enrolled.
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Use form UPAY 850 [PDF].
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Health FSA, DepCare FSA
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Enroll, de-enroll, or change your contribution (depending on the type of family change you have) without penalty during your PIE.
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Use form UPAY 850 [PDF].
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I am eligible for Core Benefits
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Benefits
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What You Can Do
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How to Do it
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Medical
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Enroll your family member in your plan or change plans. If you are not enrolled, you can enroll yourself and your family members in a medical plan.
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Use form UPAY 850 [PDF]. You many need to choose a doctor before you enroll. See Find a Doctor if you need assistance.
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AD&D
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Enroll your family member in AD&D at any time.
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Use form UPAY 850 [PDF].
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Health FSA, DepCare FSA
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Enroll, de-enroll, or change your contribution (depending on the type of family change you have) without penalty during your PIE.
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Use form UPAY 850 [PDF].
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Remember that you have a 31-day period of initial eligibility (PIE) in which to enroll your family member. If you don't enroll your family member during the PIE, you can enroll him or her during Open Enrollment. You may also enroll your family member in your medical plan at any time with a 90-day waiting period.
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Home < Employees < Making Benefit Changes < Adding a Family Member < Family Member Eligibility Chart