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<h1><img width="151" height="57" id="_x0000_i1025" src="cid:image001.png@01D8FA6B.6E5AAAB0"><o:p></o:p></h1>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">November 17, 2022<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<table class="MsoNormalTable" border="0" cellspacing="0" cellpadding="0" width="642" style="width:481.5pt;margin-left:-4.5pt;border-collapse:collapse">
<tbody>
<tr>
<td width="91" valign="top" style="width:68.3pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="font-family:"Arial",sans-serif">To:<o:p></o:p></span></p>
</td>
<td width="551" valign="top" style="width:413.2pt;padding:0in 0in 0in 0in">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:5.3pt">
<span style="font-family:"Arial",sans-serif">Department Benefits Representatives (DBRs)<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="91" valign="top" style="width:68.3pt;padding:0in 5.4pt 0in 5.4pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="font-family:"Arial",sans-serif">From:<o:p></o:p></span></p>
</td>
<td width="551" valign="top" style="width:413.2pt;padding:0in 0in 0in 0in">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:5.3pt">
<span style="font-family:"Arial",sans-serif">HR Benefits Office on behalf of UC Office of the President<o:p></o:p></span></p>
</td>
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<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="font-family:"Arial",sans-serif">Re:<o:p></o:p></span></p>
</td>
<td width="551" valign="top" style="width:413.2pt;border:none;border-bottom:solid windowtext 1.0pt;padding:0in 0in 0in 0in">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:5.05pt">
<b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:black">Open Enrollment Exception Handling Following Closure of the Fall 2022 Open Enrollment Period </span></b><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></p>
</td>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Following are instructions for handling employee requests for exceptions to the Open Enrollment deadline.
<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">The Open Enrollment portal in UCPath will close at 5 pm on Friday, November 18<sup>th</sup>. Requests for exceptions to the deadline should be sent to UCPath as described below.</span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees are encouraged to submit an
<b><i>Open Enrollment Benefits eForm </i></b>to request late enrollment after the end of the Open Enrollment period. Please note that all forms received after November 18, 2022 at 5 p.m. are not approved until reviewed. Employees should follow the steps outlined
below:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<ol style="margin-top:0in" start="1" type="1">
<li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">Log into UCPath at </span><a href="http://ucpath.universityofcalifornia.edu/"><span style="font-family:"Arial",sans-serif">http://ucpath.universityofcalifornia.edu/</span></a><span style="font-family:"Arial",sans-serif">
and enter your Single Sign-On credentials<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">On the UCPath Dashboard, select the Open Enrollment option under Forms Library<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">Choose the Benefits eForm: Open Enrollment option<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">A new eForm will populate with your personal information. Under the Reason for Request drop-down menu, select “2023 Open Enrollment”<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">Based upon your benefits primary position, please select the corresponding benefit program. The options provided are:<o:p></o:p></span></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level2 lfo1">
<span style="font-family:"Arial",sans-serif">Faculty/Staff OE Elections<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level2 lfo1">
<span style="font-family:"Arial",sans-serif">Graduate Student OE Elections<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level2 lfo1">
<span style="font-family:"Arial",sans-serif">Medical Resident OE Elections<o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level2 lfo1">
<span style="font-family:"Arial",sans-serif">Post Doc OE Elections<o:p></o:p></span></li></ol>
<li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">The Late Enrollment section will populate. You must provide details in the
<b>Reason For Late Enrollment Request</b> comment section. Please provide a detailed explanation as to why you are requesting late enrollment for the Open Enrollment period as the reason provided will be considered in the decision to approve or deny your enrollment
request. <o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l0 level1 lfo1">
<span style="font-family:"Arial",sans-serif">Make your benefit elections and submit the form.
<o:p></o:p></span></li></ol>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Once the Open Enrollment eForm has been reviewed by UCPath, a follow-up email will be sent indicating whether the enrollment request has been approved or denied.
<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees who do not have computer access may fill out paper forms to request an Open Enrollment deadline exception. Employees must fill out both the applicable Health Benefits Open Enrollment
Form (for Residents, Postdocs, or all other employees), and the Late Enrollment Request form.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">All of the applicable forms are in the UCPath Forms Library, but can also be accessed through the following links:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l1 level1 lfo2"><span style="font-family:"Arial",sans-serif">Health Benefits Open Enrollment </span><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form.pdf"><span style="font-family:"Arial",sans-serif;color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form.pdf</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></li><li class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%;mso-list:l1 level1 lfo2">
<span style="font-family:"Arial",sans-serif">Late Enrollment Request Form: </span>
<a href="https://www.ucop.edu/ucpath-center/_files/mypath/new-forms/late-enrollment-request.pdf"><span style="font-family:"Arial",sans-serif;color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/new-forms/late-enrollment-request.pdf</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level1 lfo2"><span style="font-family:"Arial",sans-serif">Postdoctoral Scholar Health Benefits Open Enrollment Form
</span><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form-postdoc.pdf"><span style="font-family:"Arial",sans-serif;color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form-postdoc.pdf</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level1 lfo2"><span style="font-family:"Arial",sans-serif">Postdoctoral Scholar Unpaid Leave of Absence Open Enrollment Form
</span><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-postdoc-lwop-form.pdf"><span style="font-family:"Arial",sans-serif;color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-postdoc-lwop-form.pdf</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level1 lfo2"><span style="font-family:"Arial",sans-serif">Medical Resident Open Enrollment Form
</span><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-medical-resident-form.pdf"><span style="font-family:"Arial",sans-serif;color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-medical-resident-form.pdf</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></li><li class="MsoNormal" style="mso-list:l1 level1 lfo2"><span style="font-family:"Arial",sans-serif">Unpaid Leave of Absence Open Enrollment Form
</span><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-lwop-form.pdf"><span style="font-family:"Arial",sans-serif;color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-lwop-form.pdf</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></li></ul>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Paper forms may be submitted in a variety of ways:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Email<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">Email address:
</span><a href="mailto:ucpath@universityofcalifornia.edu"><span style="font-family:"Arial",sans-serif;color:windowtext">ucpath@universityofcalifornia.edu</span></a><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">Email Subject: OE Late Enrollment Request<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Postal Mail<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">14350-1 Meridian Pkwy<br>
Riverside, CA 92518<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Fax<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">855-982-2329<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Create an Inquiry in UCPath<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">UCPath:
</span><a href="http://ucpath.universityofcalifornia.edu"><span style="font-family:"Arial",sans-serif;color:windowtext">http://ucpath.universityofcalifornia.edu</span></a><span style="font-family:"Arial",sans-serif"><br>
Log in using Single Sign On (SSO)<br>
Click Ask UCPath<br>
Select Submit An Inquiry<br>
Use the following drop-down selections:<br>
Topic: Open Enrollment<br>
Category: Enrollment Form<br>
Subject: OE Late Enrollment Request<o:p></o:p></span></p>
<p class="xmsonormal" style="background:white"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"><o:p> </o:p></span></b></p>
<p class="MsoNormal"><b><u><span style="font-family:"Arial",sans-serif">Appeals<o:p></o:p></span></u></b></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees whose requests are denied by UCPath may submit an appeal using the
</span><a href="https://ucnet.universityofcalifornia.edu/tools-and-services/administrators/group-insurance-appeals-process.html"><span style="font-family:"Arial",sans-serif;color:windowtext">procedures outlined on UCnet</span></a><span style="font-family:"Arial",sans-serif">.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p style="margin-top:0in"><span style="font-family:"Arial",sans-serif">If you have any questions or need assistance, please contact the UCPath Center at</span><b><span style="font-family:"Arial",sans-serif;color:black"> (855) 982-7284, Monday - Friday from
8:00 a.m. - 5:00 p.m. or email </span></b><span style="font-family:"Arial",sans-serif"><a href="mailto:ucpath@universityofcalifornia.edu">ucpath@universityofcalifornia.edu</a></span><span style="font-family:"Arial",sans-serif">.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
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