| 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 continuation coverage. Claims will not be paid for ineligible dependent. |
copy of the Notice of Termination of Domestic Partnership filed with the California Secretary
of State |
• |
|
30 days |
|
Dental |
Must be removed from your coverage within 30 days in order to qualify for continuation coverage. Claims will not be paid for ineligible dependent. |
copy of the Notice of Termination of Domestic Partnership filed with the California Secretary of State |
• |
|
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-domestic partner; 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-domestic partner; he or she may continue coverage on a direct bill basis. |
|
|
|
anytime |
|
Retirement Plans |
You may wish to review your beneficiary designation(s) and update if necessary. |
|
|
|
anytime |
|
Tuition Assistance |
A registered domestic partner whose domestic partnership with a sponsoring employee has been terminated is not eligible to receive tuition assistance. |
|
|
|
|
|
