This Life Events Guide page has two sections - active employees and retirees. Please refer to the appropriate page section for information based on your employment status. This life event does not apply to survivors.

In the table(s) below, supplemental benefits refer to supplemental dental insurance (Select, Select Plus, and Preventive), vision insurance, and Accident Plan. You may not be eligible for all supplemental benefits. Visit the Dental Insurance, Vision Insurance, and Accident Plan pages to learn about eligibility.

For Active Employees

  Health Insurance & Uniform Dental Supplemental Benefits
Enrollment opportunity? Yes, if losing other medical coverage as a dependent Yes, if losing comparable coverage
Change coverage from individual to family? Yes, if losing other medical coverage as a dependent Yes
Change coverage from family to individual? Yes Yes
Change health plan? Yes n/a
Drop a dependent and keep family coverage? Yes Yes
Cancel coverage? Yes Yes
Deadline to submit application 

File an application with your employer within 30 days of the event for all events except cancellation

Canceling coverage:   File an application with your employer within 60 days of the event

 File an application with your employer within 30 days of the event
Documentation required? Yes Upon request
Effective date

Coverage becomes effective at the end of the month after the divorce is final or after the divorced spouse is provided a Continuation-Conversion Notice (ET-2311), whichever is later

Coverage becomes effective at the end of the month after the divorce is final or after the divorced spouse is provided with continuation notices from each plan, whichever is later

 

For Retirees

  Health Insurance & Uniform Dental Supplemental Benefits
Enrollment opportunity? No, unless you are a State retiree with escrowed sick leave and are losing other medical coverage as a dependent (See Enrolling for Coverage FAQs Question: Can I delay or initiate use of sick leave credits after I retire?) Yes, if losing comparable coverage
Change coverage from individual to family? Yes, if losing other medical coverage as a dependent Yes
Change coverage from family to individual? Yes Yes
Change health plan? Yes n/a
Drop a dependent and keep family coverage? Yes Yes
Cancel coverage? Yes Yes
Deadline to submit application 

File an application with ETF (ET-2331) within 30 days of the event for all events except cancellation

Canceling coverage:  File an application with your employer within 60 days of the event

 File an application with the vendor within 30 days of the event
Documentation required? Yes Upon request
Effective date

Coverage becomes effective at the end of the month after the divorce is final or after the divorced spouse is provided a Continuation-Conversion Notice (ET-2311), whichever is later.

Coverage becomes effective at the end of the month after the divorce is final or after the divorced spouse is provided with Continuation Notices from each plan, whichever is later.