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 "Annual Enrollment 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.