New Hire/Qualifying Change in Status

Take action within 31 days of your hire date

Use BenefitsWeb to enroll in:

Medical

Supplemental Insurance

Savings & Spending Accounts

Dental

Vision

Life and Disability

Other benefits, such as legal benefits, identity theft protection, etc.

If you don’t enroll

If you do not take action:

• You will not have coverage for the remainder of this year, with the exception of Xerox-provided short term disability, long term disability, employee basic life insurance, and access to the EAP.

You will not be able to make changes until the next Annual Enrollment period unless you experience a qualifying change in status.

Want to see your options? Explore this Digital Benefits Guide to learn more about the benefits available to you. You can also:

• Use the decision support tool on BenefitsWeb to determine which medical plan is right for you.

Not sure what to do? Call 1.800.428.2203 between 8 a.m. and 8 p.m. ET, Monday through Friday to speak with a benefits expert at the Xerox Benefits Center. They can walk you through your options and answer all your benefit questions.

Enrolling in benefits

You must register as a first time user on BenefitsWeb.

• If you do not have a Registration Key, click "No, I need to request a key."
• Create your new credentials (User ID and Passcode)
• Enter the requested contact information and create your security questions.
• Authorize your device.
• Enroll yourself and your eligible dependents in Benefits.
• Be sure to confirm your elections and print a copy of your Confirmation Statement for your records.

After 31 days from your date of hire, you cannot change your benefit elections unless you experience a qualifying change in status, such as a birth or a marriage.

After your enrollment period ends, you may not change or cancel your benefit elections during 2024 unless you experience a qualifying change in status. Otherwise, your next opportunity to change your benefits will be the 2025 Annual Enrollment period.

Changes in status include:

• Birth or adoption of a child
• Marriage or domestic partnership
• Divorce, legal separation or termination of a domestic partnership
• Death of a covered dependent
• Change in employment status for you or your spouse/domestic partner that results in a gain or loss of benefits
• Change in your dependent’s eligibility for benefits
• Issuance of a qualified medical child support order
• Change in work site or residence that affects benefit plan choices

What to do if you experience a qualifying status change

To make a change, visit BenefitsWeb or call 1.800.428.2203. Changes must be made within 31 days of the change in status (60 days for birth or adoption) but cannot be submitted in advance of the event date, such as date of marriage or date of birth of child. If you add a dependent, you will be required to submit documentation.

If you experience a qualifying change in status, your benefits will be effective as of the date you experience the change in status, with the exception of supplemental insurance through Aflac; these benefits will be effective the next day. For example, if you experience a qualifying change in status on March 6, 2024, and you add supplemental insurance coverage through Aflac, your supplemental insurance coverage will be effective as of March 7, 2024.

Special Enrollment Rights

If you decline enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in a Xerox medical plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). You must request enrollment within 31 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

The plan will also allow a special enrollment opportunity if you or your eligible dependents either:

• Lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because you are no longer eligible, or
• Become eligible for a state’s premium assistance program under Medicaid or CHIP.

For these enrollment opportunities, you will have 60 days — instead of 31 — from the date of the Medicaid/CHIP eligibility change to request enrollment in the plan. Note that this 60-day extension doesn’t apply to enrollment opportunities other than the Medicaid/CHIP eligibility change.

Also, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents in a Xerox plan. You must request enrollment within 31 days after the marriage and 60 days after the birth, adoption or placement for adoption

If you are in a union – The medical, dental, vision, supplemental insurance and voluntary benefit information may apply to you. For exact details of your coverage options, refer to your union’s collective bargaining agreement or your enrollment guide posted on BenefitsWeb.