Choose your program below to learn more about making changes to coverage for the 2024-2025 plan year.
Graduate Medical Education Residents, Fellows, & Interns
Forms
- Medical Plan Enrollment & Change Form (pdf)
- Health Insurance Waiver Form (pdf)
- Dental Plan Enrollment & Change Form (pdf)
- Supplemental Life Insurance Enrollment & Change Form (pdf)
- Cancellation Request Form (pdf)
Coverage Changes
To make changes in your benefits coverage after you are first eligible or outside of the annual open enrollment period, you must have a change in family or work status. You must make your request for a change in your coverage, consistent with the family status change, within 30 days of the date of change. After the 30-day window, you will need to wait until the next available open enrollment period to make changes.
Family status changes include:
- Change in legal marital status, including marriage, divorce, or annulment
- Death of your spouse or last eligible dependent child
- Birth or adoption of your eligible dependent child
- Change in last dependent child's eligibility because of age
- Commencement or termination of employment for you, your spouse, or dependent
- Change in your or your spouse's employment status from part-time to full-time, or from full-time to part-time
At any time during the year, you can make the following changes:
- Add spouse to life insurance, subject to underwriting, up to a maximum of $150,000
- Add or increase employee additional life insurance, subject to underwriting, up to $300,000
- Add or increase child life insurance, subject to underwriting, up to $25,000
- Update your beneficiary on your life insurance plan
Birth/Adoption
You can make the following changes to your benefits due to the birth, adoption, or placement of your new child within 30 days of the event:
- Add dependent medical or dental coverage
- Add child life insurance
- Add or change the amount in your flexible spending account
Medical and Dental Coverage
You may add dependent medical or dental coverage within 30 days of the birth, adoption, or placement of your new child. Coverage is effective on the date of birth or adoption. In addition, at this time you can add coverage for your spouse who has not been covered under the plan.
If you already have family coverage, your new child is covered from the date of birth, adoption, or placement in your home.
Child Life Insurance
You may apply for child life insurance in the amount of $5,000 or $10,000 without evidence of good health, or up to $25,000 with evidence of insurability. If you already have child life insurance in effect, it is not necessary to apply to add your new dependent. The group policy automatically covers each new eligible child at live birth. Note: the benefit for children, live birth to 6 months, will be 10% of the amount elected.
Flexible Spending Accounts
You may add a dependent daycare or health care flexible spending account, or increase the amount in an existing flexible spending account within 30 days of the event. The change will take effect on the first day of the first payroll period coinciding with or following the date of the birth, adoption, or placement.
Enrollment Process
To add your new child to your benefits please submit the appropriate enrollment/change form and proof of birth (example: discharge paperwork, crib card from hospital, etc.).
Marriage
You may make the following changes within 30 days of your marriage date:
- Add your spouse to your medical or dental plan with coverage effective on the date of your marriage
- Enroll in a flexible spending account or change the amount in your current account effective with the first full payroll period following the date of your marriage
- Add spouse life insurance in amounts of $5,000 or $10,000 without evidence of good health
Submit enrollment/change forms to the Office of Student Health Benefits within 30 days to request these benefit changes. After the 30-day window, you need to wait until the next available open enrollment period to make the changes.
Enrollment Process
To add your new spouse to your benefits please submit the appropriate enrollment/change form and a marriage certificate copy.
Cancel Coverage
To request cancellation of coverage during open enrollment, complete and submit a cancellation request form during open enrollment. Because health insurance is a University requirement, if you cancel your medical plan coverage, you must also submit a health insurance waiver request form.
To request cancellation of coverage outside of open enrollment, complete and submit a cancellation request form and certificate of coverage from your new insurance provider showing proof of new coverage within 30 days of the date of change. If approved and documents are received within 30 days of the date of change, we will cancel your coverage as of the effective date of the new coverage. Because health insurance is a University requirement, if you cancel your medical plan coverage, you must also submit a health insurance waiver request form.
School of Dentistry Residents, Fellows, & Interns
Forms
- Medical Plan Enrollment & Change Form (pdf)
- Health Insurance Waiver Form (pdf)
- Dental Plan Enrollment & Change Form (pdf)
- Cancellation Request Form (pdf)
Coverage Changes
To make changes in your benefits coverage after you are first eligible or outside of the annual open enrollment period, you must have a change in family or work status. You must make your request for a change in your coverage, consistent with the family status change, within 30 days of the date of change. After the 30-day window, you will need to wait until the next available open enrollment period to make changes.
Family status changes include:
- Change in legal marital status, including marriage, divorce, or annulment
- Death of your spouse or last eligible dependent child
- Birth or adoption of your eligible dependent child
- Change in last dependent child's eligibility because of age
- Commencement or termination of employment for you, your spouse, or dependent
- Change in your or your spouse's employment status from part-time to full-time, or from full-time to part-time
Birth/Adoption
You can make the following changes to your benefits due to the birth, adoption, or placement of your new child within 30 days of the event:
- Add dependent medical or dental coverage
- Add or change the amount in your flexible spending account
Medical and Dental Coverage
You may add dependent medical or dental coverage within 30 days of the birth, adoption, or placement of your new child. Coverage is effective on the date of birth or adoption. In addition, at this time you can add coverage for your spouse who has not been covered under the plan.
If you already have family coverage, your new child is covered from the date of birth, adoption, or placement in your home.
Flexible Spending Accounts
You may add a dependent daycare or health care flexible spending account, or increase the amount in an existing flexible spending account within 30 days of the event. The change will take effect the first day of the first payroll period coinciding with or following the date of the birth, adoption, or placement.
Enrollment Process
To add your new child to your benefits please submit the appropriate enrollment/change form and proof of birth (example: discharge paperwork, crib card from hospital, etc.).
Marriage
You may make the following changes within 30 days of your marriage date:
- Add your spouse to your medical or dental plan with coverage effective on the date of your marriage
- Enroll in a flexible spending account or change the amount in your current account effective with the first full payroll period following the date of your marriage
Enrollment Process
To add your new spouse to your benefits please submit the appropriate enrollment/change form and a marriage certificate copy to the Office of Student Health Benefits within 30 days of change.
Cancel Coverage
To request cancellation of coverage during open enrollment, complete and submit a cancellation request form during open enrollment. Because health insurance is a University requirement, if you cancel your medical coverage, you must also submit a health insurance waiver request form.
To request cancellation of coverage outside of open enrollment, complete and submit a cancellation request form and certificate of coverage from your new insurance provider showing proof of new coverage within 30 days of the date of change. If approved and documents are received within 30 days of the date of change, we will cancel your coverage as of the effective date of the new coverage. Because health insurance is a University requirement, if you cancel your medical coverage, you must also submit a health insurance waiver request form.
College of Veterinary Medicine Residents, Fellows, & Interns
Forms
- Medical Plan Enrollment & Change Form (pdf)
- Health Insurance Waiver Form (pdf)
- Dental Plan Enrollment & Change Form (pdf)
- Cancellation Request Form (pdf)
Coverage Changes
To make changes in your benefits coverage after you are first eligible or outside of the annual open enrollment period, you must have a change in family or work status. You must make your request for a change in your coverage, consistent with the family status change, within 30 days of the date of change. After the 30-day window, you will need to wait until the next available open enrollment period to make changes.
Family status changes include:
- Change in legal marital status, including marriage, divorce, or annulment
- Death of your spouse or last eligible dependent child
- Birth or adoption of your eligible dependent child
- Change in last dependent child's eligibility because of age
- Commencement or termination of employment for you, your spouse, or dependent
- Change in your or your spouse's employment status from part-time to full-time, or from full-time to part-time
Birth/Adoption
You can make the following changes to your benefits due to the birth, adoption, or placement of your new child within 30 days of the event:
- Add dependent medical or dental coverage
- Add or change the amount in your flexible spending account
Medical and Dental Coverage
You may add dependent medical or dental coverage within 30 days of the birth, adoption, or placement of your new child. Coverage is effective on the date of birth or adoption. In addition, at this time you can add coverage for your spouse who has not been covered under the plan.
If you already have family coverage, your new child is covered from the date of birth, adoption, or placement in your home.
Flexible Spending Accounts
You may add a dependent daycare or health care flexible spending account, or increase the amount in an existing flexible spending account within 30 days of the event. The change will take effect on the first day of the first payroll period coinciding with or following the date of the birth, adoption, or placement.
Enrollment Process
To add your new child to your benefits please submit the appropriate enrollment/change form and proof of birth (example: discharge paperwork, crib card from hospital, etc.).
Marriage
You may make the following changes within 30 days of your marriage date:
- Add your spouse to your medical or dental plan with coverage effective on the date of your marriage
- Enroll in a flexible spending account or change the amount in your current account effective with the first full payroll period following the date of your marriage
Enrollment Process
To add your new spouse to your benefits please submit the appropriate enrollment/change form and a marriage certificate copy to the Office of Student Health Benefits within 30 days of change.
Cancel Coverage
To request cancellation of coverage during open enrollment, complete and submit a cancellation request form during open enrollment. Because health insurance is a University requirement, if you cancel your medical coverage, you must also submit a health insurance waiver request form.
To request cancellation of coverage outside of open enrollment, complete and submit a cancellation request form and certificate of coverage from your new insurance provider showing proof of new coverage within 30 days of the date of change. If approved and documents are received within 30 days of the date of change, we will cancel your coverage as of the effective date of the new coverage. Because health insurance is a University requirement, if you cancel your medical coverage, you must also submit a health insurance waiver request form.