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On June 3, we will be upgrading our benefits administration system. As part of this upgrade, the employer portal will be updated, and new user registrations will not be available until June 3. Please visit our upgrade resources and FAQs to learn more. |
| Current Location: | Home > Interactive Demonstration > Employer Connection > The NEW Online Enrollment > Online Enrollment Group Change |
May 19, 2026
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| 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 |
For individual updates, click the specific dependent you wish to maintain.
Select/Deselect All| Select | 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 |
Please select any dependents that should be changed with the same information as the Employee.
| Current Group: | 20883-000-00000-28011 FULLY INSURED |
| Enter the New Group Number: |   |
| Enter the Effective Date of the Group Change: |  Format: MM/DD/YYYY |
| Hire Date: |  Format: MM/DD/YYYY |
| ENR0007-Eff Date Does not Equal Waiting Period. Enter a Qualifying Event Code. |
| Qualifying Event: |  |
