(For information on how to remove a dependent from coverage, see last paragraph)
All completed enrollment forms
and supporting documentation may be scanned and e-mailed to Joseph.Lafond@ucdenver.edu, faxed to 303-724-6034, or mailed to the address on the form.
Benefit Options for a Newly
To add a new dependent to the CU GME Health/Dental Benefits Plan, the CU GME
Benefits Office must receive an updated CU GME Health Benefits Plan Enrollment & Change Form and supporting documentation within 31 days
of the qualifying event (e.g. marriage, childbirth). Otherwise,
dependents must wait until the open enrollment period to be eligible for
Regardless of your level of
coverage, you must add new dependent(s) to coverage within 31 days of the
qualifying event. For example, if you have the "Resident +
Child(ren)" or "Resident + Family" level of coverage you still
must complete the Enrollment & Change Form, adding your newborn, in
order for him/her to have coverage.
- Enrollment and Change Form
- Supporting Documentation: To meet
the 31-day deadline, you may submit the Birth Verification Worksheet (which is
generally given to you at the hospital) or an unofficial birth certificate that
shows the relation of parent (insured) to the newborn as a placeholder until
you receive and submit an official copy of the birth certificate.
- As soon as received,
please submit the following to the CU GME Benefits Office:
- A copy of the official
birth certificate and
- Your newborn’s social
A qualifying event may also open a 31 day special enrollment period for:
Life Insurance Update: The
beneficiary information listed on your group term life insurance policy with CU
GME may be updated at any time. To do so, print, complete and return an updated
Life Insurance Beneficiary Designation Form to the GME office via scan, fax, email, or US Postal Service.
Please be certain to sign and date the form.
Additional Forms for Adding Dependents
a Dependent from Coverage
If you wish to drop/cancel a dependent that is
currently covered under the CU GME Health/Dental Plan, please email Dee.Fetter@ucdenver.edu or
call the GME Benefits Office at 303-724-6024 for assistance.