Benefit Information & OPEN EnROLLMENT

Except during the open enrollment period, you cannot make changes to your coverage during the year unless you experience a qualifying family status change. Qualifying family status changes are listed below.

  • Marriage, Divorce, Legal Separation or Civil Union of the Employee
  • Birth or adoption of a child
  • Death or loss of a spouse or child
  • Your spouse loses coverage due to employment termination (voluntary or involuntary)
  • You or your spouse change between full time or part time employment
  • Taking an unpaid absence by the employee or Employee's Spouse
  • You have significant change in coverage because of a change in the plan of your spouse's employer
  • Your dependent loses eligibility for coverage (i.e. your child reaches the limiting age)
  • Employee or dependent becomes eligible for subsidized coverage under Medicaid or SCHIP
  • Employee or dependent’s Medicaid or SCHIP coverage is terminated due to a loss of eligibility.

If you decline enrollment for yourself and or your dependents because of other health coverage, you may in the future be able to enroll yourself and or your dependents in these plans provided you request enrollment within 30 days after such coverage ends.

If a new dependent relationship forms as a result of marriage, birth adoption or placement for adoption, you may be able to enroll yourself and your dependents provided you request enrollment within 30 days after such marriage, birth, adoption or placement for adoption. The coverage would be effective on the date of such marriage, birth, adoption or placement for adoption.

Dependents who have reached the age of 26 will be terminated from medical insurance the first of the month following their birthday. For Dental insurance, dependents must be full-time students to qualify for continued coverage. For Dental insurance, dependents who have reached the age of 25 will be terminated the first of the month following their birthday. Your dependent will be eligible for COBRA benefits at the time of termination.

HIPPA Document


Open Enrollment Period: July 1, 2020 - June 30, 2021

Only employees making changes or enrolling for the first time need to submit enrollment/change forms.

Any employee working thirty hours or more declining health insurance needs to submit a declination form for the 2020-2021 Plan Year. Submit enrollment/change/declination forms to Human Resources no later than May 15, 2020.


Employees eligible for dental insurance can enroll or make changes to their dental insurance during Open Enrollment or if there is a qualifying event during the year. If you would like to enroll or make changes (i.e., add or delete dependent) for the 2020-2021 Plan Year, please fill out a Delta Dental enrollment form. Enrollment forms need to be returned to my attention by May 15, 2020. You can scan the form and return to me by email, use inter-office mail or drop the form off in person at Central Services.

If you are currently enrolled in Delta Dental insurance and do not need to make any changes, you do not need to submit an enrollment form for 2020-2021, your and your dependent(s)' coverage will automatically roll over into the 2020-2021 Plan Year.

Employees with dependents turning 19 (age at which dependent ages out of insurance) between July 1, 2020 and June 30, 2021 that are full-time students, will need to fill out a "Student Documentation Form" and submit to Delta Dental or myself so dependent can remain on insurance.