Need To Add A Dependent
To Your Plan?
There Are Two Ways To Add A Dependent
To add a dependent to your policy, you may do so during your open enrollment/renewal period or when a qualifying life event (QLE) occurs. Examples of a QLE include a marriage, birth, or adoption. For more information on qualifying events, please click here.
Annual Plan Renewal - Open Enrollment Period
To add a dependent during your open enrollment/renewal period, you will need to fill out a new Personal Health Questionnaire (PHQ). This form is required for all members who will be covered and must answer all health questions. Once completed, the PHQ will be reviewed by Underwriting and your agent will provide you with a quote. It's important to note that all renewal adds must be completed by the 20th of the month prior to your renewal date. If submitted after the 20th, the PHQ will not be eligible and you will have to wait until the next renewal period. Click below to access and complete the PHQ.
Qualifying Life Event (QLE)
To add a dependent to your policy due to a qualifying life event, you will need to complete a new Personal Health Questionnaire (PHQ), listing all members to be covered and answering all health questions. Your completed PHQ will be reviewed by Underwriting, and you will receive a quote from your agent. QLE dependent adds must be processed within 30 days of the qualifying life event, and proof of the event must be provided by emailing it to firstname.lastname@example.org. Please note that your dependent add will not be processed until proof is received. To get started, click the button below to complete the PHQ.