Interactive Demonstration - Enrollment Maintenance - Modify

April 28, 2024

Select Member
Name	Relationship	Date of Birth	Effective Date	Termination Date
STONE, KERWIN J	Employee	02/17/1975	02/01/2007
STONE, CHARLENE J	Spouse	02/17/1975	02/01/2007
STONE, LINUS L	Child	05/21/1983	02/01/2007	02/28/2007

For individual updates, click the specific dependent you wish to maintain.

Reinstate
Name	Relationship	Date of Birth	Effective Date	Termination Date
STONE, LINUS L	Child	05/21/1983	02/01/2007	02/28/2007

Enter the Reinstatement Date:	Format: MM/DD/YYYY
Qualifying Event:

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