You have thirty days from the date of birth or adoption to add your dependent to your insurance. Forms must be completed and submitted to HR via fax: (608) 263-5778 or by attaching to an Ask HR case in ServiceNow.
If you do not enroll your new dependent within the 30-day deadline, you must wait until the next available Open Enrollment period to make changes to your benefits enrollments and the change will be effective on January 1.
Health and Uniform Dental Insurance
If you wish to enroll or add a dependent to your health insurance as a result of the birth or adoption of a child, you will need to submit a completed health insurance application/change form.
- Health Insurance Application/Change Form
- More information on Health and Uniform Dental Insurance, including premiums, coverage, etc.
If your spouse is currently covered under their own single insurance plan offered through UWHC or a different state agency, you must combine coverage so you have one family plan.
This form must be completed and receive to Human Resources within 30 days of the qualifying event date. Medical enrollment is effective the date of birth or adoption.
There are other benefits an employee can change due to a qualifying life event. Below is a list of benefits an employee could change. Refer to Employee Self Service to review your benefit eligibility.
If interested in making changes to your benefits, please complete the appropriate form and return to Human Resources.
|More Information||Enrollment Form|
|Supplemental Delta Dental (UWHC)|
|Epic Benefits+ (UWHC)||EPIC Benefits+ Application|
|Flexible Spending Accounts and Health Savings Accounts (UWHC)|
|VSP Vision Insurance (UWHC)|
State Group Life Insurance: If you are currently enrolled in State Group Life insurance and wish to increase your own coverage by one level (if not currently at the maximum) or add/increase coverage for the spouse/dependent level, you will need to submit a completed application indicating the change.
Supplemental Life Insurance: If you are currently enrolled in Supplemental Life insurance and wish to add coverage your newborn dependent, you will need to submit a completed application indicating the change.
If you wish to change your beneficiary for your life insurance and/or retirement plan savings account, you will need to complete the required beneficiary forms.
- Wisconsin Retirement System (WRS) Beneficiary Designation
- This form also updates your State Group Life beneficiaries
- Wisconsin Deferred Compensation Beneficiary Designation
For UW Employees, Inc. and Supplemental Life Insurance, call Securian at (608) 277-8690.
Please note: In the State of Wisconsin, your spouse must be listed as your 100% primary beneficiary, unless you have a notarized spousal consent on file.