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  • Insurance

Action: To remove spouse to medical/dental/vision/optional life insurance/optional AD&D effective the date of of divorce/legal separation.
    Forms »
Choices Enrollment Form
  • COBRA offered:

Action: COBRA plan offered within 2 weeks of notification; 60-day window of opportunity to make election. Coverage will begin on first of month following cancellation of coverage. Self pay premiums for up to 36 months.
    Forms » COBRA Rates

  • Optional Health Care Reimbursement Account

Action: To decrease dollar amount of election.
    Forms » Change of Status | Election Form & Compensation Reduction Agreement (In office pick-up)

  • Optional Dependent Care Reimbursement Account

Action: Can initiate account or increase dollar amount of election for daycare. Consult Benefits Specialist
    Forms » Change of Status | Election Form & Compensation Reduction Agreement (In office pick-up)

  • Taxes

Action: Change number of exemptions.
    Forms » W4

  • Beneficiary Changes

Action:You may wish to reassign beneficiary status for the following:
    Basic Life/AD&D » use the reverse side of the Choices Enrollment Form.

    Retirement »
PERS Enrollment Card (In office pick-up)
    Final Salary Payout »
Decedent's Warrant


We've got the answers to your questions concerning, Insurance Group Numbers, Care Provider Networks, Coverage ID Cards, and more. Please visit the Quick Questions site.

For additional information or assistance regarding all benefits, please contact:

Rita Garland
Benefits Services
406.243.6095 FAX

Human Resource Services

Emma B. Lommasson Center
Room 252

The University of Montana

Missoula, MT 59812

Phone: 406-243-6766

Fax: 406-243-6095