Making Changes to your dental plan:

Please keep in mind that enrollment in and changes to health insurance are only allowed during the annual open enrollment period (in October each year) or within 30 days of a qualifying family status change.

Where to send the forms:

Claim forms should be send directly to the address listed on the form.

Enrollment, change, & certification of dependent status forms, when completed, should be sent to the benefits staff within Human Resources. 

 Status change elgibility and election form  
 Certification of Dependent Status   (for child dependents age 19-25)
 Disabled Dependent Certification Form  
 claim form   (for covered services initially paid out of pocket)