In order to add/remove any dependents to your health benefit plans when experiencing a qualifying life event, please note the following requirements:

• All changes to your health benefits must be requested within 31 days of your qualifying life event. If more than 31 days have passed since the event, you will have to wait until open enrollment to add or remove any dependents.
• The employee is the only individual who can request or make any changes to their health benefits. All supporting documents and enrollment forms must be emailed/ mailed to our benefits office directly from the employee only. Any emails or requests from a spouse or any other dependent will not be accepted.
• Examples of qualifying life events include, but are not limited to the following:
  • Marriage or Domestic Partnership
  • Divorce, legal separation, or annulment
  • Birth or adoption of a child
  • Death of a spouse/partner or child
• To add or remove any dependents, ALL enrollment forms and supporting documents must be submitted to our benefits office. Supporting documents include, but are not limited to:
  • A copy of the original certificate of marriage
  • LBCC Domestic Partner Affidavit and a copy of Declaration of Domestic Partnership (if applicable)
  • A copy of official and final divorce documents
  • A copy of the official birth certificate and social security card for any child dependent
    • For newborns, a Birth Verification Letter is only temporarily accepted while parent(s) receive the official birth certificate.
    • A copy of the original birth certificate and social security card of a newborn must be submitted within 3 months of the child being born. If a copy of the birth certificate and social security card are not submitted within 3 months of birth, the child will be removed from all health coverages.
  • Official adoption documents
  • Copy of official death certificate