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Cooperative Extension Service Departments
Human Resources
Life
Changing Events
Marital Status (Newly Married,
Divorced or Widowed) •
Children (Birth, Adoption, Loss, or
Ages Out) • Serious Illness (Employee, Spouse, Child or
Parent) • Professional (Newly Hired, Promoted or Retired)
A. Marital Status
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1. Newly Married.
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a. Changing your name. You must change your name
on your SSN card first.
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b. Changing address.
- Change your address in Banner Self Service at
ban.uaex.edu under Personal Information.
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c. Adding a spouse and/or children to your benefits. You must provide copy of marriage license to Human Resources for these changes to take affect.
- i. Change Qual-Choice enrollment
information. Use form
EBEN-106.
- ii. Change Delta Dental enrollment
information. Use form
EBEN-104.
- iii. Change Life Insurance beneficiaries.
Use form
EBEN-226.
- iv. You can change your retirement beneficiaries
by going to whoever holds your retirement (e.g.
TIAA-CREF or
Fidelity) or by contacting Human Resources.
- 2. Newly Divorced.
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a. Changing your name. You must change your name
on your SSN card first.
-
b. Changing address.
- Change your address in Banner Self Service at
ban.uaex.edu under Personal Information.
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c. Removing a spouse from your benefits. You provide a copy of your Divorce Decree to Human Resources for these changes to take effect.
- i. Change Qual-Choice enrollment
information. Use form
EBEN-106.
- ii. Change Delta Dental enrollment
information. Use form
EBEN-104.
- iii. Change Life Insurance beneficiaries.
Use form
EBEN-226.
- iv. You can change your retirement beneficiaries
by going to whoever holds your retirement (e.g.
TIAA-CREF or
Fidelity) or by contacting the Human Resources department.
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d. Short-term counseling.
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3. Widowed
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a. Report death of spouse
- i. Report death to immediate supervisor.
- ii. Report death to Human Resources.
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b. Remove spouse from your benefits
- i. Change Qual-Choice enrollment
information. Use form
EBEN-106.
- ii. Change Delta Dental enrollment
information. Use form
EBEN-104.
- iii. Change Life Insurance beneficiaries.
Use form
EBEN-226.
- iv. You can change your retirement beneficiaries
by going to whoever holds your retirement (e.g.
TIAA-CREF or
Fidelity.)
-
c. Short-term counseling.
B. Children
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1. Birth of a Child
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a. Maternity Leave
The following forms need to be filled and submitted
to your immediate supervisor no later than two weeks
before leave is to begin.
- i. Application for Maternity Leave is form
EBEN-107.
- ii.
EBEN-230 and -231 Certification of Physician or
Practitioner (Family and Medical Leave Act of 1993)
and Request for consideration under the Family and
Medical Leave Act.
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b. Reducing work hours.
- i. Supervisor needs to complete form
EHIRE-100.
- ii. See
Group Benefits page for a listing on how the
insurance payments would change based on percentage
of time.
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c. Adding Your Child to Your Benefits.
- i. Cafeteria Plan -- Employee has 31 days
from the time of the child’s birth to enroll in, or
make changes to their Cafeteria plan reflecting the
addition of the child. Use form EBEN 112.
- ii. Health Plan -- Newborns are covered
from the date of birth, but they need to be added to
the employees health plan within 31 days of the
birth. Use form EBEN 106.
- iii. Dependent Life -- If the employee
has dependent life, they are covered from day 14
through 6 months for $100. After 6 months they are
covered by the level of coverage the employee has.
If the employee does not have dependent life they
can add it within 31 days of the birth.
- iv. Dental Plan -- For Dental, child can
be added within 31 days of the birth or wait until
January of the year that the child turns 3 to add
them (this helps if it is the only child - premiums
for employee and spouse are cheaper than for a
family). Use form EBEN 104.
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2.
Adoption of a Child
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a.
Bonding Leave
The following forms need to be filled and submitted
to your immediate supervisor no later than two weeks
before leave is to begin.
- i.
EBEN-230 and -231 Certification of Physician or
Practitioner (Family and Medical Leave Act of 1993)
and Request for consideration under the Family and
Medical Leave Act.
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b.
Reducing work hours.
- i. Supervisor needs to complete form
EHIRE-100.
- ii. See
Group Benefits page for a listing on how the
insurance payments would change based on percentage
of time.
-
c.
Adding Your Child to Your Benefits.
- i. Cafeteria Plan -- Employee has 31 days
from the time of the child’s adoption to enroll in,
or make changes to their Cafeteria plan reflecting
the addition of the child. Use form EBEN 112.
- ii. Health Plan -- Newborns are covered
from the date of adoption, but they need to be added
to the employees health plan within 31 days of the
adoption. Use form
EBEN-106.
- iii. Dependent Life -- If the employee
has dependent life, they are covered from day 14
through 6 months for $100. After 6 months they are
covered by the level of coverage the employee has.
If the employee does not have dependent life they
can add it within 31 days of the adoption.
- iv. Dental Plan -- For Dental, child can
be added within 31 days of the adoption or wait
until January of the year that the child turns 3 to
add them (this helps if it is the only child -
premiums for employee and spouse are cheaper than
for a family). Use form EBEN 104.
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3.
Loss of a Child
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a.
Report death of a child
- i. Report death to immediate supervisor.
- ii. Report death to Human Resources.
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b.
Remove child from your benefits
- i. Change Qual-Choice enrollment
information. Use form
EBEN-106.
- ii. Change Delta Dental enrollment
information. Use form
EBEN-104.
- iii. Change Life Insurance beneficiaries.
Use form
EBEN-226.
- iv. You can change your retirement beneficiaries
by going to whoever holds your retirement (e.g.
TIAA-CREF or
Fidelity) or contact the Human Resources department.
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c.
Short-term counseling.
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4.
Child Ages Out
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a.
Not a full-time Student
- If the child is not a full time student and
reaches age 19, then he or she has aged out of the
benefits range. The employee must complete forms
EBEN-104 and
EBEN-106 to report to insurance that the child
is no longer eligible for coverage.
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b.
Full-time Student
- If the child is a full time student and not yet
25 years old, then he or she can continue coverage
under their parent’s insurance policy. The parent is
required to send proof every semester that the child
is enrolled full-time, but this is done between the
parent and the insurance company. Extension Service
plays no part here.
C. Serious Illness
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1.
Employee Suffers a Serious Illness.
- a. Employee can apply for up to 12 weeks of
unpaid, job-protected leave during a calendar year under FMLA by filling out forms
EBEN-230 and EBEN-231.
- b. Other options that apply only to the employee are
Long Term Disability and Catastrophic Leave; however
these forms are not available over the web so the
employee must contact Human Resources for information on
these options.
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2.
Employee's Spouse Suffers a Serious Illness.
- Employee can apply for up to 12 of unpaid, job-protected leave during a calendar year under FMLA by filling out forms
EBEN-230 and EBEN-231.
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3.
Employee's Child Suffers a Serious Illness.
- Employee can apply for up to 12 weeks unpaid, job-protected leave during a calendar year under FMLA by filling out forms
EBEN-230 and EBEN-231.
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4.
Employee's Parents Suffer a Serious Illness.
- Employee can apply for up to 12 weeks unpaid, job-protected leave during a calendar year under FMLA by filling out forms
EBEN-230 and EBEN-231.
D.
Professional
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1.
Newly Hired
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2.
Newly promoted
- This requires the
EHIRE-100 form be completed to show that a
person is moving from one position to another
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3.
Retirement
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a.
Who do I notify when I decide to retire?
Upon deciding to retire you would need to:
- i. Notify the benefits manager
- ii. Notify your immediate supervisor.
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b.
What forms do I need to start my retirement?
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c.
Can I continue to carry my Extension health
insurance after retirement?
- If your total number of years in service
to Extension plus your age equals 70 and you were
enrolled in the insurance for 10 years prior to
retirement, then
you may continue your health and dental
insurance after you retire. Note that you might
be eligible for retirement before this occurs.
Any questions about this matter should be
handled by contacting the Benefits Manager
directly.
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d.
Can my spouse continue to carry my Extension health
insurance?
- As long as the employee's spouse was on
their health and dental insurance prior to their
retirement and the employee was eligible to
continue their insurance after retirement (see
c) then their spouse can remain on your policy
as well.
- e. Can I continue to carry my Extension life insurance after retirement?
- If your total number of years in service to
Extension plus your age equals 70 and you were
enrolled in the insurance for 10 years prior to
retirement, then you may keep $10,000 of life
insurance coverage. Additional life insurance
you may have can be converted. Contact the
Benefits Manager in Human Resources with any questions.
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Human Resources |
