PLAN ENROLLMENT AND BENEFIT ELECTIONS:

Each Plan Year, usually during the month of November, you will be given the opportunity to change your coverage elections for the next Plan Year.  The annual open enrollment period will begin each November 1 and end each November 30 thereafter unless the Hospital designates another period.  If you do not submit a new enrollment form for the next Plan Year, you will be deemed to have elected the same Plan benefits that you had in effect on the last day of the preceding Plan Year (for example, for the 2012 Plan Year, you would have the same benefits you had on the December 31, 2011).  Elections made during the Plan's annual open enrollment period will be effective beginning the next January 1.

Your election under the Plan will remain in effect for the remainder of the Plan Year unless you request a change on account of a change in status event.  A change in status event includes:

Also, you may modify any portion of your election affected by the following events:

ALL CHANGE IN STATUS ELECTIONS MUST BE CONSISTENT WITH THE EVENT AND SUBMITTED ON AN ELECTION FORM NO LATER THAN 31 DAYS FOLLOWING THE DATE OF THE EVENT.