Family Event Information

Did you recently experience a family event? Were you recently married or divorced? Did you have a child or adopt a child? Did you lose other group health coverage? Here are a few things you may need to consider updating within 30 days of your qualifying event:

Health Insurance

• - Add/delete dependents or, if lost other coverage, enroll.
• Wellmark Enrollment Form (PDF)

Dental Insurance

• Add/delete dependents or, if lost other coverage, enroll.
• Delta Dental Enrollment Form (PDF)

Vision Insurance

•  Add/delete dependents or, if lost other coverage, enroll.
• Avesis Enrollment Form (PDF)

Life Insurance

• Update beneficiaries.
• Sun Life and AD&D Beneficiary Form (PDF)
• Sun Life Optional Enrollment Form (PDF)

Retirement

• Update beneficiaries or change name/address.
• IPERS
  • Beneficiary Form (PDF)
  • Change of Name or Address Form (PDF)
• MFPRSI
  • Beneficiary Form (PDF)
  • Change of Name or Address Form (PDF)

Tax Withholdings

• 2021 Federal W4 (PDF) 
• 2021 State of Iowa W4 (PDF)

Flexible Spending

• Add/delete dependents or, if lost other coverage, enroll.
• Wage Works Enrollment Form (PDF)