Certain benefits may be affected by the death of a spouse/same-sex domestic or civil union partner, or child. Please take a moment to review the information below to determine if you need to take appropriate action.
- Update contact information
- Change your federal withholding allowance
- Enroll in or change health insurance coverage
- Update beneficiaries for life insurance and investment accounts. Complete the appropriate Designation of Beneficiary form.
- Change flexible spending account contributions
- Change long term care coverage
Update Contact Information
- Change your emergency contact information online.
Federal Withholding Allowance
- Make changes to your W4 form and submit it to the individual in your office responsible for processing payroll forms. You may also make changes to your W4 via Self-Service.
Health Insurance Coverage
To enroll in medical insurance or reduce your coverage, complete the
- To enroll in dental insurance or reduce your coverage, Complete the NJ State Health Benefits Program Dental Application
- Return the form(s) within 30 days of the death of your spouse/same-sex domestic or civil union partner or child to your Human Resources department.
- Your department must also submit the proper transaction in HCM payroll system.
All Pension Plan Participants
Update life insurance beneficiary information by completing the appropriate Designation of Beneficiary form and return to: Division of Pensions and Benefits, Beneficiary Services, P.O. Box 295 Trenton, NJ 08625-0295.
ABP Retirement Accounts
Update beneficiary information for investments accounts. Contact the appropriate investment carrier for their Designation of Beneficiary form:
Flexible Spending Accounts
You may elect to:
- Enroll in the Unreimbursed Medical or Dependent Care Flexible Spending Account
- Increase or decrease your annual salary deduction amount
- Cancel coverage
- Make no changes (no action necessary)
To enroll, or change your Annual Salary Deduction amount within 30 days of the death of your spouse/same-sex domestic or civil union partner, or child:
Long Term Coverage
To change Long Term Care coverage:
- Complete the Prudential Long Term Care Insurance “Long Enrollment” application. You may call Prudential at 1-800-732-0416 or visit the Prudential Long Term Care website to obtain a Long Term Care application.
Return the form to:
Prudential Insurance Company of America
P.O. Box 931
Horsham, PA 19044-0931
To cancel Long Term Care coverage:
Notify Prudential and include your name, policy/certificate number, and the date you wish to terminate the policy. Mail the letter to the above address.