Medical, Dental, and Vision Care Enrollment Form
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.
More Information
For more information about each benefit plan, see the specific benefit pages below:
Benefits - Aetna, Benefits - Dental Benefits, Benefits - Medical Benefits, Benefits - Vision Benefits