For example, if you have Self and Family coverage and you plan to keep Self and Family coverage, you do not need to complete any forms. You must let the health plan know the date of the divorce so that your ex-spouse can be removed from your enrollment. If you have Self and Family coverage and you now plan on enrolling in Self Only coverage, you must notify your Human Resources Office. You will have to complete an SF 2809.
There was an unexpected error when performing your action.
Your error has been logged and the appropriate people notified. You may close this message and try your command again, perhaps after refreshing the page. If you continue to experience issues, please notify the site administrator.