• A copy of the recorded final divorce decree must be submitted to the Plan within 60 days in order to qualify for the special enrollment opportunity and for dependents or your former spouse to be eligible for COBRA.
• In the event of a divorce, medical expenses incurred by

A completed Total Disability application and a copy of the attending physician's history and physical report must be submitted to the Pl

• A copy of the recorded death certificate must be submitted to the Plan within 60 days.

Read about how we protect your medical information, when we may use and disclose your medical information, your rights to access and request restriction to the information, and our obligation to notify you if there has been a breach of your medical information.

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