Home : DEPARTMENTS : Human Resources : Benefits/FMLA/EAS : Benefit Information

When enrolling and/or making changes to your healthcare accounts, the following documents are needed at the time of enrollment for all employees and their dependents:

• BCBS Enrollment Form
• Marriage License
• Birth Certificates or Verification of Birth
• Adoption paperwork

CHANGES TO YOUR INSURANCE ACCOUNT (during non-open enrollment):
Please complete an Enrollment Form for the following life change events:

• Marriage (please return a copy of the marriage license, if you wish to add step-children, a copy of the decree showing primary insurance responsibility is needed)
• Divorce (please return the portion of the divorce decree that show the effective date)
• Birth/adoption of a child (please return a copy of the birth certificate, for adoption include paperwork showing full custody)
• Death of a family member

Please note: not all benefit programs apply to every employee group; consult your Union Contract for more information. Insurance changes due to birth or marriage must be completed within 30-days of the event or you will need to wait until the next Open Enrollment period to apply.

forms

Teachers:

Secretaries:

Paraeducators:

Supervisors/Mangers/Coordinators & Executive Assistants:

 

Principals and Directors:  

 

 

Executive Administrators:

 

 

Maintenance, Grounds & Tech:

 

 

Childrens Programs:

 

Questions, recommendations, or problems with any of the links? Email Kristine Davis in the HR Department kdavis1@rochester.k12.mi.us