Divorce

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					                                                                                                                                                                                   Life Events
                                                                                                                                                          Divorce    or Legal Separation
                                                                                                    Benefit Choices & Considerations for Your Recent Life Event


If You’re an NCFlex Participant:                  YOUR STATE BENEFIT DECISIONS
• Contact your Health Benefits                    As a result of your divorce or legal separation, some of your bene ts are required to change. You may also make other elective bene t
  Representative (HBR) or benefits
  department to make benefits changes             changes. The following chart lists considerations by bene t and action steps you should take.
  within 30 days of your family status
  change. Changes are effective the first         FOR:                CONSIDER THESE OPTIONS:                                            TAKE THESE ACTIONS:
  of the month following the date of the          STATE               • Drop coverage for your spouse, children or stepchildren          Form Enrollment / Beacon Enrollment
  event. Online enrollment participants           HEALTH PLAN           (you may change your coverage tier).                             1. Complete the Change Form and Prior Health Coverage Information
  may make changes online.                                            • Add coverage for yourself and/or eligible dependents if             Form if you are adding eligible dependents. Forms may be found
• The changes you request must be                                       losing coverage under spouse’s medical plan (you may                on www.shpnc.org under Important Forms, Update Your Information
  consistent with your life event and                                   change your coverage tier).                                         or request one from your HBR.
  you may be required to provide                                                                                                         2. Submit the completed forms to your HBR within 30 days of the
                                                                      Important Notes:                                                      ineligibility or life event. Failure to do so within 30 days may
  documentation to your HBR.                                          • If notification is not made within 30 days following the            result in a waiting period or penalty, forfeiture of refundable
• When you legally separate, and have                                   spouse’s or dependent’s ineligibility event, the spouse and         premiums, and loss of eligibility for continuation of coverage.
  been living apart from your spouse at least                           dependent will be retroactively removed the first of the
  90 days but are not yet divorced, you have                            month following the ineligibility event, and the coverage        Online Enrollment
                                                                        type change will be effective the first of the month             1. Notify your HBR within 30 days of the ineligibility or life event.
  the option to terminate your former                                   following written notification. For example, if your divorce        Your HBR will create an enrollment event so you may make
  spouse, children and stepchildren (if                                 is final or written notification is provided on April 15, your      changes online.
  applicable) from your coverage.                                       ex-spouse will be removed effective May 1.                       2. If you are adding dependents, complete the Prior Health Coverage
• When you divorce, your former spouse                                • Your legally separated or divorced spouse and dependents            Information Form found on www.shpnc.org under Important Forms,
  (and your children or stepchildren, if                                may be eligible for continuation of coverage under COBRA            Update Your Information and submit the form to your HBR.
  applicable) is no longer eligible for benefit                         or to convert to a non-employer sponsored plan the first
                                                                        day of the month following the ineligibility event.              Continuation of Coverage
  coverage. When coverage for your former                                                                                                COBRA election forms will be mailed to you. Complete the COBRA
  spouse and children ends, they may be                               • You may not make a change in medical plan (for example,          election forms and return them within 60 days of the ineligibility event.
  able to continue health coverage under                                Basic to Plus option).
  COBRA for 36 months (until the end              NCFLEX DENTAL       • Drop coverage for your spouse, children or stepchildren,         Form Enrollment / Beacon Enrollment
  of the plan year for the HCFSA).                                      however employee must remain active.                             1. Complete the Family/Employment Status Change Form found
• If you are losing benefit coverage under                            • Add coverage for yourself and/or eligible dependents if             on www.ncflex.org under Resources, Forms.
  your spouse’s plan, you may be eligible                               losing similar coverage under spouse’s dental plan.              2. Submit the completed form and a copy of your legal separation/
  to continue your coverage. Ask your                                                                                                       divorce decree to your HBR within 30 days of the life event.
                                                                      Important Note:
  spouse’s employer for information and                               You may not make a change in dental option (for example,           Online Enrollment
  a HIPAA portability certificate.                                    Low to High Option).                                               1. Log onto www.ncflexonline.org and click on My Account.
• Some benefit changes may be subject to                                                                                                 2. Select Add Life Status Change Event and select the appropriate event
  a waiting period or Evidence of                                                                                                           from the drop down menu.
  Insurability (EOI).                                                                                                                    3. Follow the instructions displayed to complete the transaction. This
www.ncflex.org                                                                                                                              transaction opens the website for 30 days for benefit changes from
                                                                                                                                            the date of your life event.
                                                                                                                                         4. Submit a copy of your legal separation/divorce decree to your HBR.
                                                                                                                                                                              Life Events
                                                                                                   Divorce or Legal Separation
                                                                                              Benefit Choices & Considerations for Your Recent Life Event

A FEW THINGS                                   FOR:          CONSIDER THESE OPTIONS:                                                 TAKE THESE ACTIONS:
TO CONSIDER:                                   NCFLEX        • Drop coverage for your spouse, children or stepchildren.              Form Enrollment / Beacon Enrollment
• Are you and/or your dependents               VISION CARE   • Add coverage for yourself and/or eligible dependents if               1. Complete the Family/Employment Status Change Form found
  covered under your former spouse’s                           losing similar coverage under spouse’s vision care plan.                 on www.ncflex.org under Resources, Forms.
  benefit plans and now need coverage
  under the State’s benefit plans?                                                                                                   2. Submit the completed form and a copy of your legal separation/
                                                                                                                                        divorce decree to your HBR within 30 days of the life event.
• Has a court order been issued for
  child support or alimony as part of
                                                                                                                                     Online Enrollment
                                                                                                                                     1. Log onto www.ncflexonline.org and click on My Account.
  your divorce agreement?
                                                                                                                                     2. Select Add Life Status Change Event and select the appropriate event
• Do you want to change your name?                                                                                                      from the drop down menu.
  Contact the Social Security Administration                                                                                         3. Follow the instructions displayed to complete the transaction. This
  or visit www.ssa.gov for information                                                                                                  transaction opens the website for 30 days for benefit changes from
  on getting a new Social Security card.                                                                                                the date of your life event.
  Remember to check and/or change                                                                                                    4. Submit a copy of your legal separation/divorce decree to your HBR.
  other forms of identification as well
  (i.e., driver’s license, passport, credit/
                                               NCFLEX        • Drop coverage for your spouse, children or stepchildren.              Form Enrollment / Beacon Enrollment
                                               CANCER        • Add coverage for yourself and/or eligible dependents if               1. Complete the Family/Employment Status Change Form found on
  debit cards, insurance cards, etc.)                                                                                                   www.ncflex.org under Resources, Forms.
                                                               losing similar coverage under spouse’s cancer plan.
• Do you want to change your mailing                         • Change your cancer option.                                            2. Submit the completed Family/Employment Status Change Form
  address? Contact your HBR and/or                                                                                                      and a copy of your legal separation/divorce decree to your HBR
  payroll office. Remember to notify                         Important Notes:                                                           within 30 days of the life event.
                                                             • If you or your spouse/dependents are eligible for Medicaid,
  your local post office about your new                        benefits assigned under the policy are required to be assigned        Online Enrollment
  address and possible name change.                            back to Medicaid, so this may not be your best choice.                1. Log onto www.ncflexonline.org and click on My Account.
• Do you need to make changes to direct                      • EOI will be required if:                                              2. Select Add Life Status Change Event and select the appropriate event
  deposit forms, bank account information                       – you declined cancer coverage when it was first offered to             from the drop down menu.
  and/or income tax withholding (W-4                                you and your dependents and now you want to add it; or           3. Follow the instructions displayed to complete the transaction. This
  form) on your paycheck? Contact                               – you change to a higher option.                                        transaction opens the website for 30 days for benefit changes from the
  your HBR and/or payroll office.                            • EOI must be approved within 60 days after form is signed or it           date of your life event. Complete EOI information during enrollment
                                                               is automatically denied. Coverage is effective the first day of the      process when prompted.
• Do you want to update your estate                            month after EOI is approved by the vendor. For example, if            4. Submit a copy of your legal separation/divorce decree to your HBR.
  documentation, will, power of                                you are approved on May 16, coverage is effective June 1.
  attorney and beneficiary
  information? If you don’t have any of
  these, consider contacting an attorney to
  prepare them.
• Consider reviewing your life insurance
  and disability coverage needs.




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• Do you want to change your
                                           FOR:            CONSIDER THESE OPTIONS:                                            TAKE THESE ACTIONS:
  supplemental retirement plan
  withholding amount?                      NCFLEX          • Add or increase your coverage amount.                            Form Enrollment / Beacon Enrollment
                                           ACCIDENTAL      • Add/drop family coverage.                                        1. Complete the Family/Employment Status Change Form found on
• Consider contacting your Employee        DEATH AND                                                                             www.ncflex.org under Resources, Forms. Be sure to complete or
  Assistance Program (EAP) for             DISMEMBERMENT   Important Note:                                                       update beneficiary information.
  confidential counseling, information     AD&D            • If you elect family coverage and a family member suffers a       2. Submit the completed form and a copy of your legal separation/
  and referrals.                                             loss, the benefit paid is a percentage of your principal sum.       divorce decree to your HBR within 30 days of the life event.
• If you participate in any other plans                    • If you are a pilot or crew member for the State, your benefit
                                                             is limited and the cost is higher.                               Online Enrollment
  sponsored by your employer (such                                                                                            1. Log onto www.ncflexonline.org and click on My Account.
  as dental, life or cancer), check with                                                                                      2. Select Add Life Status Change Event and select the appropriate event
  the plan administrator to see what                                                                                             from the drop down menu.
  your options are and what steps you                                                                                         3. Follow the instructions displayed to complete the transaction. This
  need to take.                                                                                                                  transaction opens the website for 30 days for benefit changes from the
• Please check if your agency,                                                                                                   date of your life event. Complete EOI information during enrollment
  university or community college                                                                                                process when prompted. Be sure to update your beneficiary information.
  sponsors any additional benefit                                                                                             4. Submit a copy of your legal separation/divorce decree to your HBR.
  plans that may be impacted by your       NCFLEX GROUP    • Add or increase your coverage amount.                            Form Enrollment / Beacon Enrollment
  recent life event.                       TERM LIFE       • Drop or decrease your coverage amount.                           1. Complete the Family/Employment Status Change Form found on
                                                                                                                                 www.ncflex.org under Resources, Forms. Be sure to complete or
                                                           Important Notes:                                                      update beneficiary information.
                                                           • EOI will be required if:                                         2. Visit www.ncflex.org for the EOI form.
                                                              – you declined Group Term Life coverage when it was             3. Submit the completed Family/Employment Status Change Form, EOI
                                                                 first offered to you and now you want to add it; or             form, and a copy of your legal separation/divorce decree to your HBR
                                                              – you increase your existing coverage amount.                      within 30 days of the life event.
                                                           • EOI must be approved within 60 days after form is signed
                                                             or it is automatically denied. Coverage is effective the first   Online Enrollment
                                                             day of the month after EOI is approved by the vendor.            1. Log onto www.ncflexonline.org and click on My Account.
                                                             For example, if you are approved on May 16, coverage is          2. Select Add Life Status Change Event and select the appropriate event
                                                             effective June 1.                                                   from the drop down menu.
                                                                                                                              3. Follow the instructions displayed to complete the transaction. This
                                                                                                                                 transaction opens the website for 30 days for benefit changes from the
                                                                                                                                 date of your life event. Complete EOI information during enrollment
                                                                                                                                 process when prompted. Be sure to update your beneficiary information.
                                                                                                                              4. Submit a copy of your legal separation/divorce decree to your HBR.
                                           NCFLEX          • Enroll in or increase your contributions to the account.         Form Enrollment / Beacon Enrollment
                                           HEALTH CARE     • Drop or decrease contributions to the account.                   1. Complete the Family/Employment Status Change Form found
                                           FLEXIBLE                                                                              on www.ncflex.org under Resources, Forms.
                                           SPENDING        Important Notes:                                                   2. Submit the completed form and a copy of your legal separation/
                                           ACCOUNT         • Health care expenses incurred prior to your effective date          divorce decree to your HBR within 30 days of the life event.
                                            HCFSA            under the HCFSA or outside of the plan year are not
                                                             eligible for reimbursement.                                      Online Enrollment
                                                           • Reimbursement of expenses incurred prior to the change           1. Log onto www.ncflexonline.org and click on My Account.
                                                             date will be limited to your original account maximum and        2. Select Add Life Status Change Event and select the appropriate event
                                                             not to the new higher maximum.                                      from the drop down menu.
                                                           • Consider adding the NCFlex Convenience Card for you              3. Follow the instructions displayed to complete the transaction. This
                                                             and your dependents, so you do not have to wait for                 transaction opens the website for 30 days for benefit changes from the
                                                             reimbursement.                                                      date of your life event.
                                                           • Changes to your contribution amount are subject to the           4. Submit a copy of your legal separation/divorce decree to your HBR.
                                                             annual minimum of $120 and maximum of $4,200.




www.ncflex.org
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                                                                                                                                                                Life Events
                                                                                                                                                  Divorce
                                                                                                                                                      or Legal Separation
                                                                                           Benefit Choices & Considerations for Your Recent Life Event


YOUR BENEFIT DECISIONS
FOR:         CONSIDER THESE OPTIONS:                                        TAKE THESE ACTIONS:
NCFLEX       • Enroll in or increase your contributions to the account.     Form Enrollment / Beacon Enrollment
DEPENDENT    • Drop or decrease contributions.                              1. Complete the Family/Employment Status Change Form found on
DAY CARE                                                                       www.ncflex.org under Resources, Forms.
FLEXIBLE     Important Notes:                                               2. Submit the completed form and a copy of your legal separation/
SPENDING     • Dependent day care expenses incurred prior to your              divorce decree to your HBR within 30 days of the life event.
ACCOUNT        effective date under the DDCFSA or outside of the plan
 DDCFSA        year are not eligible for reimbursement.                     Online Enrollment
             • Reimbursement of expenses incurred prior to the change       1. Log onto www.ncflexonline.org and click on My Account.
               date will be limited to your original account maximum        2. Select Add Life Status Change Event and select the appropriate event
               and not to the new higher maximum.                              from the drop down menu.
             • The IRS limits a family filing a joint return to a maximum   3. Follow the instructions displayed to complete the transaction.
               of $5,000 of DDCFSA deductions per calendar year.               This transaction opens the website for 30 days for benefit changes
             • Consider adding the NCFlex Convenience Card for you             from the date of your life event.
               and your dependents, so you do not have to wait for          4. Submit a copy of your legal separation/divorce decree to your HBR.
               reimbursement.
             • Changes to your contribution amount are subject to the
               annual minimum of $120 and maximum of $5,000.
STATE        • Review your beneficiaries.                                   1. Contact the Retirement System to review your beneficiaries.
RETIREMENT   • Update your name and address.                                2. If you wish to change your beneficiary(ies), complete Designating                       North Carolina
                                                                               Beneficiaries for Retirement System Contributions Form 2C found
                                                                               on www.myncretirement.com or obtain by calling 1-877-627-3287
                                                                               (toll free) or 1-919-807-3050 in Raleigh.
                                                                                                                                                         State Health Plan
                                                                                                                                                         Teachers’ and State Employees’ Comprehensive Major Medical Plan

                                                                            3. Contact your HBR to update your name and address.




                                                                                                                                                        www.ncflex.org
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