Dependent Eligibility Verification

If you wish to add a dependent who was not previously covered under any of your benefits, add a new beneficiary, or update full-time student status for children ages 19 to 25, please complete the Dependent/Contact Add-Update Form and submit it with the appropriate supporting documentation to the Employee Benefits & Work/Life Department. The completed form may be submitted via fax to 274-1670 for your convenience. You will not be able to enroll new dependents until you submit the appropriate paperwork and it is processed.