Page 4 - Quarles

How to Enroll

You may enroll by using our online portal (see enclosed instructions) or
by paper application for each benefit.

Changing Elections after You Enroll

The benefit elections you make when you enroll cannot be changed
until the next annual Open Enrollment period unless you have a
qualifying event, such as:

? Marriage or divorce
? Birth, adoption or legal custody of an eligible dependent
? Death of your spouse or dependent
? Dependent covered by the plan becomes ineligible
? Change from full-time to part-time status, or vice versa, by you or

your spouse
? Significant change in your spouse's coverage attributable to

employment
? Termination or commencement of spouse's employment
Your change in election must be consistent with the change-in-status event. For example, if you get married,
you can drop your medical coverage (if your spouse adds you to his or her employer’s plan) or you can add
your spouse to your current coverage.
If you want to make changes to your benefits as the result of a qualified change in status, you must notify
Human Resources within 30 days of the change in status. If you do not notify Human Resources within 30
days of the qualified change, you must wait until the next annual Open Enrollment period to enroll or make
changes to your current benefit elections. Please keep in mind that documentation may be required to confirm
the change in status.

3 2016-2017 Benefits Guide