State Group Health Insurance
If you have Family coverage, submit a Health Insurance Change Form to report your marital status change in the event of your spouse's death or to report the death of a child. An application is required to change to Single coverage if there are no other eligible family members. Applications should be submitted to the UWM Benefits Office.
State Group Life Insurance: Minnesota Life Insurance Company
If Spouse and Dependent coverage is in effect, notify the UWM Benefits Office. The UWM Benefits Office will send you a form to be returned with a certified death certificate. If no other family members are eligible for coverage, you should submit an application/cancellation form to stop deductions for Spouse and Dependent coverage. The application should be submitted to the UWM Benefits Office.
Individual and Family Group Life Insurance: Minnesota Life Insurance Company
If the deceased was insured, notify the UWM Benefits Office. The Benefits Office will send you a form to be returned with a certified death certificate. To stop deductions for Spouse and/or Dependent coverage, you should also submit a coverage change form to the UWM Benefits Office.
Accidental Death & Dismemberment: Zurich Insurance Company
Notify the UWM Benefits Office if the deceased was insured and the death was accidental. If there are no remaining eligible dependents, you should submit an application to change to "Employee only" coverage.
Major Medical and Dental Insurance: Epic
Notify the UWM Benefits Office if the deceased was insured and the death was accidental. If you are changing from Family to Two-Person coverage or Two-Person to Single coverage, submit a change form to the UWM Benefits Office.
Dental Insurance
Unclassified Employees and Non-Represented Classified Employees
An application to change to Single coverage will be needed if there are no remaining eligible dependents. Contact the UWM Benefits Office.Represented Classified Employees
An application to change to Single coverage will be needed if there are no remaining eligible dependents. Contact your union local.
Employee Reimbursement Account Program
If you have a Dependent Care or Medical Expense account in effect, you may be able to adjust or cease your contributions. The change you make must be consistent with how the death of your spouse or child has affected your expenses in these areas. If you do not have an ERA account in effect, you may be able to start one or both. You must submit a completed Family Status Change Form to Fringe Benefits Management Company within 30 days of the death.
You would also have the opportunity to waive the automatic premium conversion part of the ERA program, or retract a waiver if you had waived this benefit previously. You must take action within 30 days of death.
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Last modified: January 5, 2004
