Gain or Loss of Coverage in another Employer's Plan

Medical and Dental

• Add medical and dental coverages by submitting the Qualifying Status Change form (Formerly - Application to Change Insurance Coverage), if coverage is disenrolled with the other employer due to the employment status change.
• Following the request to add a dependent, you will be asked to provide proof of dependent eligibility. A detailed letter asking for the appropriate documentation will be sent to your home.
• Drop medical and dental coverage by submitting the Qualifying Status Change form (Formerly - Application to Change Insurance Coverage), if coverage is enrolled with the other employer due to the employment status change.
• If you are dropping medical coverage for yourself, and you receive the full employer contribution, you must also submit the Waiver of Medical Coverage form and provide acceptable proof of other coverage for yourself, your spouse, and eligible dependents.
• You cannot change your medical or dental claim administrator.

Pre-tax Accounts

• You may increase your Medical Dental Expense Account (MDEA) if you or your dependents lost other employer coverage due to the employment status change.
• You may decrease your MDEA if you or your dependents gain other employer coverage due to the employment status change.
• You may change your Dependent Care Expense Account (DCEA) if your expenses have changed based on the change in work status.

Medical and Dental

• You must add medical and dental within 30 days of the employment status change, including the date of the change.
• You must drop medical and dental within 60 days of the of the employment status change, including the date of the change.

Pre-tax Accounts

• Changes to pre-tax benefits must be made within 30 days of the employment status change, including the date of the change.

Timing is everything

• An enrollment is completed by submitting the required forms to the SEGIP office no later than the last day of the enrollment period.
• Do not delay submitting your application by the deadline. Call SEGIP at 651-355-0100 within your enrollment period when there is a delay obtaining documents. Otherwise, late applications will not be processed.
• If the enrollment is not completed within the allowed period, your next opportunity to change your coverage is during the next annual Open Enrollment or upon another qualified life event.

• Changes to medical and dental are effective the date of the other employer’s effective/termination date.
• Changes to your MDEA pre-tax account take effect on the event date or the first day of the pay period in which SEGIP receives your completed form, whichever comes later.

These changes can be made to your benefits at any time:

• You can make changes to Employee Additional Life, Spouse Life, Employee AD&D, Spouse AD&D, and Short Term Disability, by completing the Optional Application form.
• You can make changes to your Parking Expense Account (PKEA) and Bus Pass/Vanpool Account (BVEA) by completing and returning to SEGIP the Transit Change in Participation form.

Be sure to make these updates if needed:

• Name changes: submit this change to your Human Resource office.
• Address changes: you update your address in Employee Self Service.
• Tax withholdings: contact your agency’s payroll department.
• Retirement account: contact MSRS at [email protected], 651-296-2761, or 800-657-5757.
• Life and AD&D beneficiary changes: Securian Financial (Minnesota Life). 

Visit our Find a Form page to access the form you need.

If you need a form to make changes to your pretax accounts, visit the Benefit Resource (BRI) website.