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  • Medical, Dental, and Vision Care Enrollment Form

Medical, Dental, and Vision Care Enrollment Form

More Information

For more information about each benefit plan, see the specific benefit pages below:

  • Medical Benefits
  • Dental Benefits
  • Vision Benefits

For Employees Experiencing a Qualifying Life Event

Does not include newly eligible due to change in hours or status

If you are experiencing a qualifying life event, such as marriage, divorce, birth, or adoption, please complete an online request through the Duke@Work self-service website to enroll or make changes to the health, dental, and/or vision plan. The request and required supporting documentation must be submitted within thirty (30) days of the event.

Form Name Format
Medical, Dental, and Vision Care Enrollment
(use the "Qualifying Life Event Enrollment" link)
Web

 

For Newly Hired or Newly Eligible Employees

If you are a newly hired or eligible employee, you may enroll online through the Duke@Work self-service website to participate in the health, dental, and/or vision plan. Make your benefit selections carefully as you will not be able to make changes afterward until the next annual open enrollment period, unless you have a qualifying life event. Enrollment must be completed during the first thirty (30) days after your date of hire or your date of eligibility.

Form Name Format
Medical, Dental, and Vision Care Enrollment
(use the "New Hire Enrollment" link)
Web

 

If you are having trouble accessing Duke@Work please contact your departmental payroll representative. If you are having difficulty with the benefit enrollment link, please contact the HRIC at 684-5600.

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  • Benefits Forms
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Human Resources

Duke Human Resources
705 Broad St. Box 90496
Durham, NC 27705
Phone: (919) 684-5600
Have questions?

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