This page allows you to assign and edit dependents.

All fields which include an * indicate a required entry.

This page allows you to submit multiple dependents. Each dependent must be added one at a time. To add a dependent, complete the page and select 'Update dependents'. Continue this process until you have entered all dependent information.

When you have entered all the dependent information, select 'save all changes' to submit the dependent information to the plan administrator.

In the event that the required fields are not completed or the data entered is invalid, a message will appear indicating an error. To correct a validation error for a dependent, select the appropriate dependent name hyper link and modify the highlighted field.