Generally, you may make membership changes (for example, change from an individual membership to a family membership) only if you have a change in family status such as:
• Marriage or divorce.
• Birth, adoption or change in custody of a child.
• Death of an enrolled spouse or dependent child.
• The loss of an enrolled dependent’s eligibility under the subscriber’s membership. For
example, when an unmarried dependent child or a full-time student dependent reaches the
maximum dependent age to be covered under this health plan, his or her coverage ends
under the subscriber’s membership.
If you want to ask for a membership change or you need to change your name or mailing address,
you should call or visit the MIT Affiliate Health Plans Office (E23-308, 617-253-4371) or write
affplan@med.mit.edu. You must request the membership change within the time period required
by MIT. If you do not make the change within the required time period, you will have to wait until
the group’s next enrollment period to make the change. All membership changes or any additions
are allowed only when they comply with the eligibility and enrollment rules set by MIT for your
group health care benefits and the conditions outlined in this Summary Plan Description
