Legal Seperation Checklist

Things to Do
	You must drop your spouse and former stepchildren from medical and dental coverage. Your Pretax Health Care Premiums will be adjusted accordingly.	Within 30 days from date of legal separation
	Notify the Employee Services Organization of the address change for your former dependents for COBRA notification.	Within 30 days from date of legal separation
	You are now eligible to change your existing Dependent Care and/or Health Care Reimbursement Accounts.	Within 30 days from date of legal separation
	Notify the GUL Program Administrator to drop your former spouse from payroll billing. Change your beneficiary, if appropriate.	No Limit
	Notify the Long-term Care Program Administrator to drop your former spouse's coverage and/or your former spouse's covered family members.	No Limit
	Contact LifeWorks for tips on ways to explain separation to your kids.	No Limit
	Look into the professional services offered by your local Employee Assistance Program (EAP) provider.	No Limit
	Change your name (including preferred name), address and phone number, if applicable. If you changed your name, notify all the necessary parties related to your YourCorp activities of your name change, such as IT for e-mail and voicemail accounts, your Credit Union, your HMO, First Health, Harris Bank, and Fidelity Investments.	No Limit
	Change your emergency contact, if necessary.	No Limit
	Review and change your beneficiary designations, if applicable.	No Limit
	You may cancel your YourCorp stock book-entry joint account and/or change the name on your YourCorp stock certificates.	No Limit
	Contact the QDRO Representative for guidance regarding a Qualified Domestic Relations Order, if applicable.	No Limit
	Contact your Credit Union to make any necessary changes to your account(s).	No Limit
	Review your W-4 form election for federal/state/local tax withholding and change if appropriate.	No Limit
	Note: YourCorp must comply with all wage garnishments. If you have a question about a garnishment, call the Employee Services Organization and ask for the garnishment specialist.	No Limit