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Keeping Your Coverage Current

To make sure you receive all the benefits you are entitled to, you must keep your records accurate. Make sure you report changes to us within 30 days of their occurrence so we can process the change and pay your claims. Don't forget to keep your address up to date.
Use our New Enrollment/Change of Status Form (186K PDF) to notify us of any of the following events:
  • New enrollments
  • COBRA enrollments
  • Contract changes
  • Address changes
  • Name changes
  • Cancellations
  • Reinstatements
Complete and submit the form according to the instructions located on the form. Additional instructions (141K PDF) for completing this form are available.

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