Status Change - Spouse/Dependent Coverage Loss

If a spouse or an eligible dependent loses their medical/dental/and or vision coverage through their employer, they may be able to be added to your coverage at the time of loss of coverage.  Proof of loss of coverage must be provided to Human Resources.  The proof should be an official letter from the previous employer that includes the following information:

  • Name of person(s) losing coverage
  • Social Security Number(s) and birth date(s) of person(s) losing coverage
  • Date coverage was terminated
  • The length of time coverage had been provided.