Open Enrollment is your only opportunity to make changes to your coverage, unless you experience a qualified change in status.

"Qualifying Event" includes but is not limited to:

• Marriage, divorce, or annulment;
  
• The birth or adoption of a child;
• The death of your spouse or child;
• A change in the number of your dependents;
• A change in employment status for you, your spouse, or your dependent that results in a change of insurance eligibility.

A qualifying event must be reported within 60 days of the date of the event. 

Due to Health Care Reform policy changes, the above-mentioned status changes for dependent children may be subject to revision based on future amendments to regulations that govern "changes in status" for cafeteria benefits plans. Failure to report the qualifying event timely may result in a reversal of claims, which will become your financial responsibility.

Need to request a change?

Benefit forms can be found online at www.leegov.com/hr/employees/forms. Completed forms must be submitted to Human Resources via email at benefits@leegov.com, fax (239) 485-2052 or in person.

You may contact the Benefits Division in Human Resources directly at 239-533-2245.

Need to add a Spouse or Dependent to your Benefits?

The Human Resource Benefits Team will need the following to add a dependent to your benefit plan:

To Add Spouse:

• Marriage License
• Social security card
• Driver's License or Passport
• Spouse COBRA acknowledgement form

To Add Dependent:

• Birth Certificate
• Social security card
• Legal documentation for adoption, fostering, or court appointed guardianship
• Stepchildren: marriage license, birth certificate