You can enroll eligible dependent at any time. To remove dependents or cancel coverage, there are two opportunities for employees to make changes:
1. Qualifying Life Events
If you experience a qualifying life event you have the opportunity to add or remove dependents from your coverage or make other changes to your benefit elections. To make changes outside of open enrollment, employees must complete and submit the PEBTF-2 Enrollment/Change Form to your human resources office within 60 days of the event occurring.
2. Open Enrollment – Every Fall
The PEBTF health plan runs January 1 through December 31. Open Enrollment is the time of year for you to evaluate your medical options to decide which plan works best for you and your family.
You may add/drop dependents during annual open enrollment. You will need to provide original documentation that verifies your dependent’s eligibility for coverage, e.g., birth certificate, marriage certificate, and court-approved adoption order. You must submit any required original eligibility documentation prior to your dependent being enrolled in the health plan.
Instructions for Open Enrollment (Enroll or Make Changes) Through Self Service Workplace,
FIORI
All changes must be made online using the self-service workplace, Fiori.
- Go to FIORI: (https://workplace.passhe.edu) and Sign in.
- On the tiles, select My Benefits Enrollment.
- Follow the enrollment directions here.
- Review and retain the email confirmation to verify open enrollment changes. If you do not receive an email confirmation of open enrollment changes, contact your human resources office prior to the end of open enrollment.
For additional questions or information, please contact your university human resources office.