Remember to review and update your beneficiary designations whenever there is a big life event to make sure that your benefits are paid according to your wishes. There are other benefit plans (non- life insurance) that have death benefits as well.
Forms & Applications
Forms and applications must be received by your human resources office within 30 days from the date of event.
If you or your dependents lose comparable coverage elsewhere (such as through a spouse’s plan or employment), you may have opportunities to enroll in the following plans with the UW System.
You must submit an application to enroll within 30 days of the loss of other coverage, or within 30 days of the notice of loss of coverage, whichever is later. Note: This does not include voluntary cancellation of the other coverage.
Click on the benefit plan below to see your options. Visit the Forms page for all plan applications, forms and brochures.
- You may enroll in single coverage if you have lost eligibility elsewhere
- You may enroll in limited family or family coverage if you and your dependent(s) have lost eligibility elsewhere
- You can change from single to limited family or family coverage if your dependent(s) have lost eligibility elsewhere and you are enrolling those dependent(s).
- If you are already enrolled in limited family or family coverage, you can add the dependent(s) that have lost eligibility elsewhere to your benefit plans
Coverage is effective on the day following the last day of the other coverage. For example, if your coverage ends on March 13th with the other plan, coverage under the plans above would begin on March 14th.
NOTE: You must provide documentation from another employer plan or insurer stating that you or your dependent(s) lost eligibility for coverage and the date that the other coverage ended. This documentation must be dated and issued after the termination of coverage.
Health Care FSA | Limited Purpose FSA (LPFSA)
- You may enroll in or increase your Health Care FSA or LPFSA contributions if eligibility under another employer health plan is lost.
- You cannot cancel or decrease your Health Care FSA or LPFSA contributions.
Dependent Day Care FSA
- You may enroll in or increase your Dependent Care FSA contributions if your spouse or domestic partner loses eligibility for Dependent Day Care FSA through his or her employer.
- You may decrease or stop your Dependent Day Care FSA contributions if your spouse or domestic partner will be staying at home to care for your qualified dependent(s).
Changes are effective the first of the month on or following receipt of your Change of Election form.
Employees are required to re-enroll in these FSAs every year during the Annual Benefits Enrollment period to continue participation. Elections will not automatically continue into the next plan year.
If not currently enrolled: Enrollment in the HSA is required if you are eligible for and enroll in the HDHP or Access HDHP plan design. You must also be eligible for the HSA.
If currently enrolled: You can change your contribution amount at any time up to the annual maximum limit. The change will be effective as soon as administratively possible.
last updated: 7/17/17