| Benefit Plan |
What You Need to Do |
Documentation Required |
eTrac |
Paper |
When |
 |
Medical |
Must be removed from your coverage within 30 days in order to qualify for COBRA rights. Claims will not be paid for ineligible dependent. |
copy of the divorce or annulment decree |
• |
|
30 days |
|
Dental |
Must be removed from your coverage within 30 days in order to qualify for COBRA rights. Claims will not be paid for ineligible dependent. |
copy of the divorce or annulment decree |
• |
|
30 days |
|
Flexible Spending Accounts |
Start or change the amount of a health care or dependent care FSA |
copy of the divorce or annulment decree |
• |
|
30 days |
|
Dependent Life Insurance |
No longer covered under policy. If only dependent covered, need to stop dependent coverage. |
|
• |
|
anytime |
|
Supplemental Accidental Death and Dismemberment |
No longer covered under policy. If only dependent covered, need to stop dependent coverage. |
|
• |
|
anytime |
|
AFLAC |
Contact AFLAC at (800) 992-3522 to discontinue payroll deductions for your ex-spouse or spouse from whom you have legally separated; he or she may continue coverage on a direct bill basis. |
|
|
|
anytime |
|
Long Term Care |
Contact John Hancock at (888) 524-6167 to discontinue payroll deductions for your ex-spouse or spouse from whom on a direct bill basis. |
|
|
|
anytime |
|
Retirement Plans |
If you need information about preparing a qualified domestic relations order to divide assets held in your retirement plan, please contact the Office of Benefits Administration. You may wish to review your beneficiary designation(s) and update if necessary. |
|
|
|
anytime |
|
Tuition Assistance |
Legally separated or former spouse is not eligible for tuition assistance. |
|
|
|
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