Participating in a Dental Plan

Changing Your Elections

Generally, once you have elected a dental plan and coverage level, you cannot change your elections until Open Enrollment, unless you have a qualifying change in status or special enrollment event as explained below.

Qualifying Change in Status includes:

Marriage, divorce, legal separation or annulment.

Registration or termination of a domestic partnership.

Death of a child, spouse or domestic partner.

Birth, adoption or placement for adoption of a child.

Dependent reaching maximum plan age of 23.

Loss of eligible dependent status.

A court order which requires that a dependent be covered under your dental coverage.

The above situations require documentation consistent with the qualifying change in status. Dental elections can only be changed mid-year for the above situations. Changing for any other reason may only be made during annual open enrollment.

If you have one of the above qualifying change in status situations, you must complete a change form within 31 days of the change. Any change in your elections must be consistent with and on account of the qualifying change in your circumstances.

Verification of relationship is required for any dependent being added for the first time to your coverage.  Documentation may include a marriage certificate or domestic partnership statement to add a new spouse or domestic partner. Documents for a new dependent child may include a birth certificate or adoption papers, or other appropriate legal documents may be provided.  Return a copy of the required documents to the Benefits Office within 31 days of the qualifying change.

While this Summary Plan Description summarizes the major provisions of this plan, it does not provide you with every plan detail. The plan documents, which govern this plan, provide full details. If there are any discrepancies between this Summary Plan Description and the legal plan documents, the legal plan documents control.