There are certain events in your life, such as birth or marriage, which allow you to enroll in coverage. These Qualifying Life Events create a Special Enrollment Period (outside of the annual Open Enrollment Period) during which time you can enroll in this Benefit Plan or enroll in another plan offered by your employer (if you are eligible to enroll in that plan). Examples of Qualifying Life Events Include:

• Marriage/Divorce
• Birth/adoption of a child
• Loss of coverage

In the case of birth, adoption or placement for adoption, you have 31 days to request special enrollment for this Benefit Plan, for all other Qualifying Life events, you have 30 days to request special enrollment for this Benefit Plan.

If you do not complete the enrollment application in that time period and provide any other necessary documentation upon request, you and your dependents will not be allowed to enroll until your employer’s next Open Enrollment Period, unless another Qualifying Life Event occurs.