Disclaimer: If the information on this page conflicts in any way with HCA documentation, the HCA documentation governs.

This Life Event is when a court order, legal guardianship, or national medical support notice requires you to provide insurance coverage for an eligible dependent child.

Changes You Can Make To Your Benefits

When this Life Event happens, you can make the below changes to your benefits. Note that your requested changes must be received by the ISC no later than 60 days after the date of the court order.

• Enroll in medical and dental coverage in order to, in turn, enroll a dependent child who is required to be enrolled by a court order. Existing other dependents who are not covered under the court order may not be enrolled.
• Add the dependent child who is required to be enrolled by a court order to your medical/dental plan. Existing other dependents who are not covered under the court order may not be enrolled.
• Remove an eligible dependent child from your health plan if they are enrolled under the coverage of another individual who is required by a court order to provide the child’s insurance coverage.
• Change your medical and/or dental plan if the child named in a court order does not reside in the service area of your current health plan.
• Enroll in an FSA or increase your FSA contribution amount only if required by a court order for the employee’s dependent child.
• Change your Tobacco Use Attestation response.*

How To Make Changes

1. Download and complete the Employee Enrollment Change form linked in the right-hand sidebar of this page.
2. Gather/scan documentation that serves as proof of your new dependent – provide one of the following:
   • Valid court order
     -OR-
   • National Medical Support Notice
3. Mail or email (preferred) the completed form and supporting documentation to UWHR Benefits.

• Your requested changes must be received by the ISC no later than 60 days after the date of the court order.