Find out which documents are required when adding a spouse or dependent to your insurance or making changes due to a qualified life event. Having the correct paperwork will help ensure a smooth update to your coverage.
Program Option
Local Annuitant Health Program (LAHP)
Local Deductible Health Plan (PO14) & Supplemental Benefits
Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
Local Health Plan (PO16) & Supplemental Benefits
Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
Local High Deductible Health Plan (PO17) & Supplemental Benefits
Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
Local Traditional Health Plan (PO12) & Supplemental Benefits
Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
State Employee and Retiree Health Plan & Supplemental Benefits
The Duty Disability Insurance Program is an income replacement program. Duty disability benefits may be payable to protective occupation participants if you have been injured while performing your duties or contracted a disease due to your occupation.
ET-1141
Manual
Active Employee /
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer
For UWs only: This guide provides an overview of the rules, event, and date triggers that enable a qualifying life event and/or change reason to occur.