OSBA (Anthem) Enrollment and Change Form

Making a change to your insurance enrollment

If you need to make a change to your board-paid insurance enrollment, you can do so in three easy steps:

1.  Make sure you have qualifying event.  These events include:
      A. Termination of employment
      B.  Exhaustion of COBRA benefits
      C.  Employer no longer offers group coverage
      D.  Status Change/ Reduction of Hours
      E.  Marriage
      F.  Birth/Adoption
      G.  Divorce/Legal Separation

2.  Download and fill out a change form.
      Change form   (Directions are on page 1)

**Important** - You only have 30 days from your qualifying event to turn this paperwork in.  After 30 days, changes may not be able to be made!

3.  Call Becky Toebben!
Mrs. Toebben can help you through this entire process!  When you are ready to make a change, unsure if you need to make a change, or have any questions, call Mrs. Toebben at 636-456-6901; or email her at [email protected]
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