Human Resources > Benefits > FAQs > Health & Welfare FAQs > How do I remove a family member from my insurance?

How do I remove a family member from my insurance?

Complete a UPAY 850 form, indicating the dependent you wish to remove. Send it to your Benefits Office.

You may remove a dependent from your insurance at any time.

If your dependent has lost eligibility involuntarily (i.e. due to divorce, marriage or change in tax dependency), you must also complete a UBEN 109. The dependent may be eligible to continue coverage under COBRA. The Benefits Office will provide the COBRA packet directly to the dependent.

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