My Benefits: Submit Life Event

	View Eligible Benefits

	View Enrolled Benefits

	Perform Open Enrollment

	Submit Life Event

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Submit Life Event
Submit Changes


Submit Life Event	Benefits	Submit Changes

Qualifying Life Event(s) Recorded:

Adoption of a Child (03/12/2003)

Changes made to:

Blue Care Network HMO	Change Effective Date:	03/12/2003
Vision Service Plan	Termination Effective Date:	03/12/2003
Dependent Care FSA	Enrollment Effective Date:	03/12/2003

You have X days from the date of the event to submit a change. If you let the X days elapse, you must wait until the next Open Enrollment period to make the change. Any changes made must be consistent with the qualifying event experienced.

To submit another life event, click Submit Life Event from the sub-navigation bar, located just below the title of the page. To make additional changes to your benefits, click Benefits.

If you decide to make changes at a later time within the period specified above, you will be able to do so by clicking the "Submit Life Event" link, from the front page or from the My Benefits section of the left side navigation bar.

Important Note: Please note that you must click the Submit button, in order for your employer to receive and process your changes. You may submit changes one at a time or make multiple or all changes before submitting them.

If this information is correct, click Submit.

X days is the numbers of days assigned by the ER via Manage Enrollment Process > Life Events.