Step 1: Submit Request Form

A benefit change request form must be completed within Employee Self Service and submitted to University Benefits to request this change. 

How to submit a request through Employee Self Service:

Note: If you would like to change your health care and/or dependent care Flexible Spending Account amounts due to a qualifying event, you must fill out the Salary Reduction Agreement form and submit it to University Benefits. You are not able to make mid-year changes to your FSA accounts through Employee Self Service.
  • Log in to your Employee Self Service site with your HawkID and password,
  • Go to your "Benefits & Wellness" dashboard button,
  • Under the Benefits Section, select the link "Benefit Change Request."
  • Choose the event requiring a need for a change, fill out the remainder of the form and submit it to our office.

Note: For the "Date Event Occurred" field, please enter the date of when the event happened. Changes will take effect the first day of the month after the event date. For change requests related to birth or adoption, change takes effect the first day of the month in which the event occurs. Please review the examples below:

  • Your spouse loses their coverage and will be covered on their current insurance until May 31, 2021. You will want to put the May 31 date in the "Date Event Occured" field. This will ensure that their coverage with the university will begin on June 1, 2021, which is when they would no longer be covered under their previous policy. If you were to enter June 1 as the effective date in the "Date Event Occured"  field, your spouse's coverage would not begin until July 1, 2021. Changes will take effect the first day of the month after the event date. An exception to this rule is the example below;
    • You have a new baby or adopt, born, or adoption was finalized on May 16, 2021. You will want to put in the actual date of birth/adoption of May 16, 2021. Baby/adoptees will be covered with the university beginning May 1, 2021. Changes will take effect the first day of the month when the baby was born or adoption was finalized.

You are not done! This is a two-step process. First, please watch for an email from the Benefits Change Request Team. This email alerts you that you may go back into Employee Self Service and work your benefits change.

Step 2: Make Your Benefits Changes

After receiving your approval email from the Benefits Change Request Team—approximately 24 hours following form submission—you can make your benefit changes in Employee Self Service under the Benefits Enrollment link.  

Note: If your request is received during the last six working days of the month, University Benefits cannot make changes until the second working day of the following month.

You will be notified by email when final confirmation of your elections is available for your review, approximately 24-48 hours after submitting your new elections. If a correction is needed, follow the steps from your Benefits Confirmations page in Employee Self Service. You will have one week from the date of your initial elections to request a change.

If you added a new dependent(s), please read Step 3 and plan to take the required action. 

Step 3: Verify Dependents

University Benefits now collects information to verify dependents enrolled in our health and dental plans. To cover your spouse, domestic partner, and/or dependent children, action will be required on your part.

After enrolling in benefits, you will receive an email from our office asking you to verify eligibility for those you added to your plans. If complete documentation is not received within four weeks, your unverified dependent will be removed from coverage and cannot be added without a qualifying event.

Please visit the dependent eligibility process and information webpage for more information and review the required documentation list. It is always a good idea to start collecting your documents as soon as possible, as you may need to order a new copy of a specific document.