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Qualifying Event/State Plan Changes

Add or Drop Employee and Dependent
Health and Dental Coverage

If you experience an eligible qualifying event, you may add or drop yourself and your eligible dependents to/from any of the health plans and the dental plan. If you elect not to participate in the dental plan, any enrolled dependents will also not have dental coverage. Please view additional details on dependent coverage.

TO ADD OR DROP COVERAGE click the Continue button below. When adding a same-sex spouse, a paper Group Insurance Enrollment form must be submitted to your campus UPB Benefits Services office. Please contact your campus UPB Benefits Services office if you need assistance.

Note: When adding a dependent, proof of dependent eligibility is required. See dependent documentation requirements and deadlines.


Maintained by University Human Resources | Contact Information | Last Update: 05-June-2015 | ID: 23