Enrolling in a Health Insurance plan when you did not elect to do so when you were first eligible:
If you did not elect to enroll in any health insurance plan offered by the AgCenter within 30 days of your hire date, or when you were first eligible, you may enroll at any time. However, there are rules that affect effective dates of the plan that should be paid special attention. When you enroll, you will be considered a Late Applicant. If appropriate forms are turned into HRM by the 10th day of the month, the effective date will be the 1st day of the following month. If forms are turned into HRM after the 10th day of the month, the effective date will be the 1st day of the second month following. Forms necessary are: GB-01, Pre-Existing Condition Acknowledgement form and the Portability Law Application along with the proof the person(s) you are adding is a legal dependent.
Certain circumstances may make you eligible for Special Enrollment, which has a different deadline as well as additional documentation. Special Enrollment will be permitted for employees or dependents for whom the option to enroll in coverage was previously declined because the employee or dependents had other coverage that terminated due to certain circumstances. Examples of these circumstances include: loss of coverage because of divorce, termination of employment of spouse, termination of COBRA coverage or reduction in hours. Please contact HRM for further details.
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Adding someone to your health insurance plan:
If you are newly married and trying to add a spouse, have a dependent child that has recently resumed full-time student status or just had a baby, you’ll need to add those individuals within 30 days of the change in status for an effective date of the coverage to be the date of the event. (e.g. forms to add a newborn baby are signed and dated within 30 days of the baby's birthdate would ensure an effective date that would be the same as the birthdate, provided forms are submitted to the HRM Office within a timely manner.) Forms signed and dated after 30 days of the event would mean the newly acquired dependent would be considered a late applicant.
Persons without a qualifying event are considered late applicants and can be added anytime, but there are a few forms to fill out. (The effective date of coverage depends on when the forms are received in HRM. You will need to contact us for details about the effective date.) You’ll need the GB-01, the Pre-Existing Condition Acknowledgement and the Portability Law Application. Persons with a qualifying event will only need to complete the GB-01and the Flexible Benefits Status Change Form (if their premiums are currently tax sheltered) to submit along with the proof the person you are adding is a legal dependent within 30 days of the event. The completed forms with original signatures will be submitted to Human Resources, along with proof the dependent is legally insurable by you (e.g. birth certificate, marriage certificate, adoption paperwork). If you have questions about filling out the forms properly, call Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Deleting someone from your health insurance plan:
If your premiums are tax sheltered, a qualifying event will be necessary to justify the removal (a comprehensive list can be found on this form). The GB-01 and the Flexible Benefits Status Change Form with original signatures will be submitted to Human Resources within 30 days of the status change. If your premiums are not tax sheltered, a GB-01 alone will work. If you have questions about filling out the forms properly, call Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Changing your name:
In order to change your name, you will need to fill out this form, attach a copy of your new Social Security card and send both to your unit's office manager because a Personnel Action Form will also need to be completed. Your unit office manager will send all paperwork to Human Resources. You will also want to consider where else you may need to change your name. Reviewing the payroll deductions on your payroll deposit slip should help you to remember other agencies or companies that will need to be notified of the change. If you have an Optional Retirement Plan or any Supplemental Retirement Accounts, contact the carriers directly.
Dental Insurance – Call 1.800.487.5553, this Voluntary Benefits Change Form will also work. Submit to HRM.
Vision Insurance – Call 888.729.5433 x2013, this Voluntary Benefits Change Form will also work. Submit to HRM.
Teachers' form – To be sent directly to Teachers’.
LASERS form – To be sent directly to LASERS.
If you have questions about how to change your name, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Changing your address:
In order to change your address, you will need to fill out this form and send it with original signatures to Human Resources. You will also want to consider where else you may need to change your address. Reviewing the payroll deductions on your payroll deposit slip should help you to remember other agencies or companies that will need to be notified of the change. If you have an Optional Retirement Plan or any Supplemental Retirement Accounts, contact the carriers.
Dental Insurance – Call 1.800.487.5553, this Voluntary Benefits Change Form will also work. Submit to HRM.
Vision Insurance – Call 888.729.5433 x2013, this Voluntary Benefits Change Form will also work. Submit to HRM.
Teachers' Retirement form
LASERS form
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Changing your health insurance coverage:
If you would like to switch from one health plan to another, there is only one time during the year to do so – Annual Enrollment. Our Annual Enrollment election takes place between April 1 and April 30 of each year. Benefit changes go into effect July 1.
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Dropping your dental and/or vision insurance:
In order to eliminate dental or vision coverage at a time other than Annual Enrollment, (April 1 – April 30) without experiencing a qualifying family event, (a comprehensive list can be found on this form) you must not have your premiums tax sheltered. If you do have your premiums tax sheltered and meet the criteria for a qualifying event, complete the Flexible Benefits Status Change Form as well as the Voluntary Benefits Change/Cancellation Form. If you do not have your premiums tax sheltered, the Change/Cancellation Form alone will work. Submit all with original signatures to Human Resources within 30 days of the status change. If you have questions about how to drop your dental and/or vision insurance, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Updating your tax withholdings:
You may elect to change your deductions at any time. Your current elected deductions are printed on your payroll deposit slip, available through PAWS. Changes can also be made through PAWS. The W-4, L-4 and L-4E forms can be accessed by selecting the Employee Resources link from the PAWS desktop, then select Tax Withholding. Select the tax withholding form to complete, then click GO. Changes made through PAWS application will take effect within two business days. If you wish to change or update these preferences on paper, you may fill out the most recent L-4 and W-4. Submit with original signatures to Human Resources. If you have questions about how to complete the information, instructions are printed on the forms.
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Changing your beneficiary for retirement or life insurance, ad&d coverage:
You may elect to change your beneficiary at any time.The most recent beneficiary on record will be valid. Direct links are provided below. Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
Retirement –
LASERS, Teachers', LA Deferred Compensation
Optional Retirement – You will need to contact the carrier – VALIC, ING, TIAA-CREF
Life Insurance –
Prudential, LSU Supplemental Life, Extension Benevolent, LSU First Life Insurance
AD&D Coverage - Stand Alone Group Accident Insurance
LSU Group Accident Insurance (Beneficiary Information can be amended for the AD&D Insurance on the second page of this form, the Summary Sheet.)
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Congratulations! You’ve just gotten married.
First – You will need to take action to make any changes to your insurances within 30 days of the marriage. There are a few things to consider. Do you have to change your name, your address, update your taxes, select a new beneficiary(ies), add someone to your dental, vision or health insurance plan or switch to your spouse’s coverage? Do you need to consider amending your Tax Saver Plan contributions (healthcare and dependent care spending accounts)? To amend the premiums under the Tax Saver Plan, you’ll need the Flexible Benefits Status Change form as well as a new form that will list your amended contributions for the plan year. Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resource (225.578.2258) and a benefits representative will be able to assist you.
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When you get divorced:
First – You will need to take action to make any changes to your insurances within 30 days of the divorce. There are a few things to consider. Do you have to change your name, your address, update your taxes, select a new beneficiary(ies), delete or add someone to your dental, vision or health insurance plan? Do you need to consider amending your Tax Saver Plan contributions (healthcare and dependent care spending accounts)? To amend the premiums under the Tax Saver Plan, you’ll need the Flexible Benefits Status Change form as well as a new form that will list your amended contributions for the plan year. Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Congratulations! You’ve just had a baby:
First – You will need to take action to make any changes to your insurances within 30 days of the baby’s birth. Do you need to update your taxes, amend your beneficiary(ies) or change your Tax Saver Plan contributions? To amend the premiums under the Tax Saver Plan, you’ll need the Flexible Benefits Status Change form as well as a new form that will list your amended contributions for the plan year. You may need to add the infant to your health insurance policy. In order to do this, a GB-01 must be completed and accompanied with a birth letter from the hospital noting the date and place of the birth. The office of Group Benefits requires a copy of the birth certificate once it is received. If a copy of the birth certificate is not submitted within 1 year, the infant will be dropped from coverage. If your premiums are tax sheltered, you will also need to submit the Flexible Benefits Status Change form. Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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You have adopted a child:
First – You will need to take action to make any changes to your insurances within 30 days of the adoption date. Do you need to update your taxes, amend your beneficiary(ies) or change your Tax Saver Plan contributions? To amend the premiums under the Tax Saver Plan, you’ll need the Flexible Benefits Status Change form as well as a new form that will list your amended contributions for the plan year. You may need to add the infant to your health insurance policy. In order to do this, a GB-01 must be completed and accompanied with the proof the child is now a legal dependent. If your premiums are tax sheltered, you will also need to submit the Flexible Benefits Status Change form. Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Someone you have insured has died:
You will need to contact the office of Human Resources (225.578.2258). Ask to speak to someone in benefits. For each insurance policy, a certified copy of the death certificate is necessary for claims submissions. If the deceased was a dependent on health, or dentalvision insurance, they will need to be removed. You may need to amend your contribution to your health care or dependent care spending accounts. If the deceased was a beneficiary for any of your retirement or supplemental retirement accounts, this information will need to be updated. If the deceased was an employee and there is a surviving spouse and/or children, contact Human Resources and a benefits representative will be able to assist you.
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Your dependent child has turned 21:
In order to continue insurance coverage for a dependent child once the age of 21 is reached, proof of full-time student status is required. The Office of Group Benefits will accept a letter from the registrar or the combination of the student’s schedule with a $0 balance fee bill. Verifications from www.studentclearinghouse.com are also acceptable forms of proof. (The website service does charge a nominal fee.) If the proof is not received by Human Resources by the end of the month the child reaches 21, there will be a disruption in coverage. To avoid this, it is encouraged to submit proof of full-time student status at the beginning of the semester in which the child will reach age 21. [Please note: Pre-Registration letters are NOT acceptable forms of proof.] Proof of full-time student status is required for every semester the student is in school until s/he reaches age 24 or marries. If your dependent child has reached age 21 and is no longer a full-time student, they will need to be removed from health, dental and/or vision coverage.
Once proven, coverage dates for each semester are as follows: (Quarter system is by quarter)
Fall: 09.01.2xxx – 12.31.2xxx
Spring: 01.01.2xxx – 08.31.2xxx
Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Your dependent child has graduated from college:
In most cases, once your dependent child has graduated from college, s/he must be removed from your health, dental and vision insurance coverage. However, if the dependent child has graduated, will continue into graduate school and has not reached the age of 24, they may continue on as an insured dependent, continuing to provide proof of full-time student status.
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Your dependent child has turned 24:
Once your dependent child has turned 24, s/he must be removed from your health, dental and vision insurance coverage. S/he will be covered until the end of the month of his/her 24th birthday. The first day of the following month is the effective date for deletion.
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your dependent child (over 21 and under 24) resumes full-time student status:
First – You will need to take action to make any changes to your insurances within 30 days of the start of the semester/quarter. In order to add your dependent child back to your insurance coverage, proof of full-time student status must accompany a GB-01 and a Flexible Benefits Status Change form (if your premiums are tax sheltered). Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Your dependent child marries:
Once your dependent child marries, s/he must be removed from your health, dental and vision insurance coverage. S/he will be covered until the end of the month of his/her wedding date. The first day of the following month is the effective date for deletion.
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Changing your Tax Saver Plan Contributions:
You must have a qualifying event to change the contributions to your health care or dependent care spending account - unless the change in election is made during Annual Enrollment (April 1 - 30). Qualifying events are listed on the Flexible Benefits Status Change form. That form will accompany the enrollment form noting your change in contribution amount. Once completed, forms with original signatures must be submitted to Human Resources. If you have questions about how to complete the forms, please contact Human Resources (225.578.2258) and a benefits representative will be able to assist you.
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Changing your direct deposit information:
Once your new account has been set up, you will want to fill out this form. Submit the original to Human Resources for updating.
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Changing your Campus Federal deductions:
If you would like to change your Campus Federal deductions, you will need to fill out this form. Submit the original to Human Resources for updating.
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Determining Retirement Eligibility:
Each of the Retirement Systems has eligibility requirements. This chart is an easy to use source of information.
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