Get Qualified Life Status Change Form - Fedex Benefits Online

Filling out the Qualified Life Status Change Form is an essential process for updating your benefits after a significant life event. This guide provides step-by-step instructions to ensure you accurately complete the form online.

Follow the steps to complete your Qualified Life Status Change Form online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering your last name, first name, and middle initial in the designated fields. This information helps to identify your request.
3. Provide the date of the qualifying event. Ensure this date is within 31 days as it is crucial for processing.
4. Enter your Social Security number and telephone number to enable communication regarding your submission.
5. Fill in your KID number if applicable. This information assists in your identification within the benefits system.
6. Select the qualifying event that applies to your situation by checking the relevant box. Ensure you attach the required documentation as specified.
7. For each dependent affected by this change, provide their name, relationship, date of birth, and gender in the specified sections.
8. Indicate whether you want to add or delete each dependent from your medical, dental, vision, and life insurance by marking the appropriate options.
9. For flexible spending accounts, specify the annual amount you wish to have deducted, knowing that this will be taken from each paycheck.
10. Select the supplemental life insurance coverage amount you wish, paying attention to the provided notes regarding potential evidence of insurability.
11. In the statement/signature section, confirm your agreement with the statements presented by signing and dating the form.
12. After reviewing all information for accuracy, save changes to the form, and choose to download, print, or share it as necessary.

Complete your Qualified Life Status Change Form online to ensure your benefits reflect your current life situation.