Permitting Permitting Event Effective Date of Permitting Event Time to File Document Event Code Date Action Change of custody or adding who has 16 Date of custody Standard 60 days from event become economically dependent on change or employee including economic dependency economically created through a court order. dependent child is acquired New spouse, domestic partner and/or 17a Date family Standard 60 days from stepchild(ren) to a one enrollment. member acquired Spouse, domestic partner and/or dependents 17b Date other Mandatory (*) 60 days from that lost coverage to a one party enrollment coverage ended (except voluntary cancellations). Return from military 18 Date of return Standard 60 days from event Newborn, adopted child, or a child at each 19 Date of birth, Standard 60 days from birthday through age 6 to a one party physical custody or enrollment. birthday until age 6 New spouse, domestic partner and/or 21a Date family Standard 60 days from event stepchild(ren) to a two or more party member acquired enrollment. Spouse, domestic partner and/or dependents 21b Date other Mandatory (*) 60 days from event that lost coverage to a two or more party coverage ended enrollment (except voluntary cancellations). Newborn, adopted child, or a child at each 22a Date of birth, Standard 60 days from event birthday through age 6 to a two or more party physical custody or enrollment. birthday until age 6 (*) For the addition of a domestic partner or same-sex spouse being claimed as a dependent for dental benefits the party code would say for a party code of 2 or for a party code of 3 or more. A or B party codes are used only if the domestic partner or same-sex “A” “B” spouse are not being claimed as an economic dependent by the employee. Dental Program
Permitting Event Permitting Event Code Permitting Event Date Effective Date of Action Time to File Document Change of custody or adding who has become economically dependent on employee including economic dependency created through a court order. 16 Date of custody change or economically dependent child is acquired Standard 60 days from event New spouse, domestic partner and/or stepchild(ren) to a one enrollment. 17a Date family member acquired Standard 60 days from Spouse, domestic partner and/or dependents that lost coverage to a one party enrollment (except voluntary cancellations). 17b Date other coverage ended Mandatory (*) 60 days from Return from military 18 Date of return Standard 60 days from event Newborn, adopted child, or a child at each birthday through age 6 to a one party enrollment. 19 Date of birth, physical custody or birthday until age 6 Standard 60 days from New spouse, domestic partner and/or stepchild(ren) to a two or more party enrollment. 21a Date family member acquired Standard 60 days from event Spouse, domestic partner and/or dependents that lost coverage to a two or more party enrollment (except voluntary cancellations). 21b Date other coverage ended Mandatory (*) 60 days from event Newborn, adopted child, or a child at each birthday through age 6 to a two or more party enrollment. 22a Date of birth, physical custody or birthday until age 6 Standard 60 days from event (*) For the addition of a domestic partner or same-sex spouse being claimed as a dependent for dental benefits the party code would say “A” for a party code of 2 or “B” for a party code of 3 or more. A or B party codes are used only if the domestic partner or same-sex spouse are not being claimed as an economic dependent by the employee. Dental Program