Life Event/Status Change

Benelogic Online Benefits Enrollment

View or Download Benelogic Instructions (576K, .ppt)

Certain qualifying life events allow you to make a change to your benefits outside of the open enrollment period. A change in family status may create the need for a different level of coverage, e.g., Individual, Two-Party, or Family, and may affect the amount of your payroll deduction for healthcare. Your change request must be made through the Benelogic online enrollment system no later than 30 days following the effective date of one of these qualifying events. You must send documentation of the qualifying event to the Benefits Office within the same time period in order for the change request to be authorized. Below are examples of qualifying events for status changes:

Event	Verification Examples
Marriage, divorce or annulment	Marriage certificate, divorce decree
Birth, adoption, or death of a dependent	Birth record, crib card, baby's footprints from hospital, death certificate
Change in employee or spouse's employment status (termination, layoff, start new job)	Certificate of Coverage or letter on employer's letterhead showing effective date of change, coverage, and employee/subscriber name(s)

For more detailed information on Status Changes due to Qualifying Events see pages 3 and 4 of our Plan Summary Description . Changes in benefit elections resulting from a change in family status must be consistent with the family status change. 

TO REQUEST STATUS CHANGES DUE TO A QUALIFYING LIFE EVENT, FOLLOW THESE STEPS:

1. Log on to the CCPS Benelogic Online Benefits Enrollment Employee Portal.
2. Read carefully the instructions on each screen and select your change(s). (See Benelogic Instructions PowerPoint for overview.) Remember that Basic and Supplemental Life Insurance Beneficiary additions or changes are to be made through Benelogic also.
3. View and print a confirmation statement of your change request for your records.
4. Mail or fax the appropriate documentation to verify your change to the Benefits Office within 30 days of your change effective date. Change(s) will be effective the first of the month following date of status change.

OTHER INFORMATION YOU MAY NEED DUE TO A STATUS CHANGE:

W-4 Form (.pdf) - required for address changes

Designation of Beneficiary (Form 4) for State Retirement/Pension System (.pdf)

If necessary, print, complete, and send completed form to the Benefits Office.

Name changes require a new Social Security card.

For instructions on how to apply for a new card:

For requests or information not found under Forms, contact the Benefits Office at rmmorgan@ccps.org or 410-996-5415.