Supporting Documentation:
1. Proof of gained coverage - new insurance information which includes the effective date of coverage, type of coverage, and name(s) of the applicable individual(s) who are enrolled in the coverage.
And, if applicable:
2. Waiver of Medical Insurance Form - If you are waiving coverage for yourself, you may also be required to submit a Waiver of Medical Insurance Form if you fall into one of the following groups: 1) MEA, Local 145, Local 127, DCAA, and Unrepresented/Unclassified hired on or after July 1, 2020; or 2) POA and Local 911 hired on or after July 1, 2021.
Special Instructions:
To process your requested changes, supporting documentation (e.g. proof of gained coverage and, if applicable, Waiver of Medical Insurance form) will need to be submitted to Risk Management within 30 days of the Qualifying Event. If you have supporting documentation available now, you may attach it to the Qualifying Event form. If you do not have supporting documentation at this time, you may submit the form without attachments and Risk Management will work with you as you obtain your documentation. Communication regarding your qualifying event will be processed through your SAP Portal Inbox.