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Welcoming a new child into your family means you may change your benefit enrollment without having to wait until the annual open enrollment period.
  • Insurance

Action:Add child to medical/dental/vision/optional life insurance/optional AD&D, effective on the date of birth.
    Forms » Choices Enrollment Form

  • Optional Health Care Reimbursement Account

Action: To start account, or increase dollar amount of election; new or increased amount can only be used after the date of birth.
    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)

  • 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 (In office pick-up).

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

Action: Change number of exemptions.
    Forms » W4

  • FMLA Leave

Action: The use of sick leave, optional use of annual leave, donated sick leave and/or sick leave fund.
Consult Benefits Specialist
    Forms »
FMLA Request for Leave (In office pick-up/completed by Employee/Employer)
Leave of Absence (completed by Employer)

Sick Leave Recipient Form (completed by Employee, approved by Employer)
Direct Sick Leave Grant Form (completed by Donators)
Sick Leave Fund Contribution Form (completed by Employee)
    Resources »
FMLA Procedure
Sick Leave Fund/Direct Sick Leave Grant Policy


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