Once the designated Annual Enrollment period has closed, employees have one opportunity to revise their Annual Enrollment elections, provided they submit the request to Benefits Administration no later than 4:30 p.m. CT on Dec. 1 of the current plan year. Timely submitted revisions will become effective on Jan. 1 of the upcoming plan year.
The employee must submit the Enrollment Change Application with "Other - AE Revision" marked in Part 1. Annual Enrollment revision elections should be made on the form, and the required dependent verification should be submitted with the form.