Life or Employment Changes

Normally, your benefit elections remain in effect from January 1 through December 31, and you may only make changes during Annual Enrollment. However, if you experience a qualifying life/employment status change during the year, you may be able to change some of your benefit elections.

You must make any eligible changes within 31 days after the event, or wait until the next Annual Enrollment period. Changes are not automatic—in other words, the birth of a baby does not automatically enroll the child under your coverage.

To make a benefits change, complete this form and return with the appropriate supporting documents to

What's a qualifying status change?

You must make any modifications to your benefit elections within 31 days following the date a life event change occurs, or you will have to wait until the next Annual Enrollment period. Qualifying life events are:

Qualifying Life Event Changes Supporting Documentation Required to Validate the Event


Marriage License

Divorce or Legal Separation

Divorce Decree or Court document for Legal Separation addressing benefit coverage

Dissolution of domestic partnership

Completed and notarized dissolution of domestic partnership form.

Death of a spouse, domestic partner or a dependent

Death certificate


Birth certificate

Adoption or placement for adoption or foster care of a child

Adoption paperwork or court appointed document for placement of adoption/foster care

Termination of employment (or commencement of employment) of a spouse

COBRA notification for spouse’s coverage or letter from employer showing that the spouse gained coverage with coverages identified

Dependent child losing eligibility for health care coverage

Documentation required other than limiting age requirement (23 for Dependent Life and 26 for Medical, Dental and/or Vision coverage). Provide letter or documentation showing gain of coverage elsewhere.

Switching from full-time to part-time status by the teammate*/spouse

Teammate: Completed Affidavit – Request to Cancel Health Care Coverage

Teammate’s Spouse: Letter and/or other documentation from the spouse’s employer reflecting the change in spouse’s job status

Significant change to health coverage that is attributable to the spouse’s employment

Letter and/or other documentation from the spouse’s employer reflecting the significant change (ex. Significant increase in employee premiums, significant increase in deductibles/coinsurance/out-of-pockets, etc.)

You can make modifications to your benefit elections within 31 days of your eligibility date if you:

  • Convert from full-time hourly to part-time hourly status*
  • Convert from part-time hourly to full-time hourly or salaried status
  • Commence or return from an unpaid leave of absence

If moving from a part-time to full-time hourly or salaried status, you can obtain a Benefits Resource Guide here.

If you are converting from full-time hourly to part-time hourly status and would like to waive your medical benefits, please contact the Benefits Department.

If you are commencing or returning from an unpaid leave of absence, please contact the Benefits Department.


*Under ACA, converting to part-time will not allow you to drop your medical coverage. However, if you gain coverage under a qualified medical plan, you may be able to revoke your coverage through the Company. Contact Benefits at –800-690-7655, ext. 3012, option 5 or

Changing your coverage must be consistent with the type of Life Event

If the change does not in any way impact your benefit coverage or your ability to pay for it, then it cannot be used to justify a change.

Note: If your benefit change results in increased coverage (for example, changing from single to family medical coverage), a back charge may be deducted from your pay to cover the new premium rate.

Having a baby?

If you, your spouse or your domestic partner enrolls in the Company medical plan, you are eligible for telephonic education and support programs during your pregnancy. There is no cost to you, and all calls are strictly confidential.

Just contact your carrier, and a maternity nurse specialist will get you started right away. Throughout your pregnancy, the specialist will work with you to help make your pregnancy go smoother and assist you in having a healthy baby.

  • Detailed health and lifestyle assessment
  • Facts about pregnancy and birth
  • Personalized counseling
  • Individualized educational materials
  • Help in choosing a doctor, midwife or pediatric caregiver, if necessary
  • Helpline available 24 hours a day

Covering your dependents and documents required

Make sure you know whom you can cover. If you're adding a dependent, see what you'll need to verify eligibility. Plus, the ACA requires us to provide your dependents' Social Security numbers.

Learn more about covering dependents and the documents required to verify your dependents.

Need help or have questions?

Contact Benefits at 1-800-690-7655, ext. 3012, option 5 or by email for information, forms, etc.

Want to know more?

Use the MarketLink Spending Account Service Center Savings Calculator.
Estimate your life insurance needs. Click here for an online calculator or click here.
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