"NEW HIRE" State Health Plan ENROLLMENT forms MUST be in Human Resources on the 19th of the month (to process paperwork for payroll deadline). Otherwise, NEW HIRES will have to wait until the following month to enroll in the State Health Plan.

If the 19th falls on a weekend or state holiday NEW HIRES State Health enrollment forms need to be in HR the last business day prior to the 19th.

State Health enrollment forms received after the 19th of the month, coverage will be effective the 1st of the second (following) month.

EX: John Doe begins employment on September 1st, his State Health ENROLLMENT form should be in HR by the 19th of September if he wants his health care coverage to begin October 1st.

**Any premium will be deducted on his September 30th pay. (Premiums are pay in ADVANCE of coverage)

EX: If John Doe begins employment on September 1st and his State Health ENROLLMENT form is not in HR until September 20th, then his health care coverage will N0T begin until NOVEMBER 1st.

**Any premium will be deducted on his Oct 31st pay.

State Health Plan "CHANGE FORMS" are due in HR by the 15th of the month PRIOR to the effective date of change.

EX: If John Doe needs to change his health care effective Sept. 1st, then he needs to have his CHANGE REQUEST FORM into HR by August 15th.