If you are participating in our benefits program for the first time & will be enrolling dependents or designating a beneficiary,
you will need to add them to this page by clicking the Add button at the top of the page.
If adding your spouse, you will need to update their tobacco status under the additional information field.
Your spouse’s tobacco status will affect your insurance rates if enrolled.
In order to comply with Healthcare Reform 1095 reporting requirements, dependent & spouse names must be entered exactly as they appear on their social security card.
If they are already listed, please review their information and make any necessary edits.
Incorrect information may result in coverage delays. After completing this page, select next to continue.