DECIDE

After learning the choices, programs and resources, decide what is right for you and your family in 2025. Follow these steps if you are enrolling in or updating coverage.

1
 2025 Plan enrollment or changes for Medical, Dental or Vision Plans.  Complete a benefit enrollment form.
Waive your ShopRite Supermarkets medical benefits.  Complete a waiver form.
2 Decide who will be covered. If needed, provide Marriage License and/or Child(ren) Birth Certificate(s).
3 Flexible Spending (FSA) Health Care or Dependent Care - optional.
 Use the above benefit enrollment form. Section D.
4 Life Insurance - if this is your initial benefit eligibility   Complete life enrollment form.
Anytime you can update your beneficiary form (Page 3).   Complete beneficiary form.
5 Optional Voluntary Supplemental Life Insurance Plan - elect coverage.
Anytime other than initial benefit eligibility, Evidence of Insurability (EOI) is required.  Complete EOI form.
6 Long Term Disability Benefits (LTD) - How do you want to receive your benefit?  Complete LTD enrollment form.
7 MetLife Legal - optional  Complete MetLife Legal enrollment form.
8 MetLife Insurance for Home, Auto or Pet Insurance - optional Call MetLife anytime 1-800-438-6388
mybenefits.metlife.com

Email your forms to srsbenefits@wakefern.com


Who is eligible?

  • Your spouse to whom you are legally married. If your spouse is eligible for medical coverage through his/her employer, then he/she is not
    eligible for primary medical coverage through ShopRite.
  • Your dependent child(ren) until the end of the month he/she turns age 26. For example, if your child was born March 2, 1999, your child is eligible for medical, dental, and vision coverage until March 31, 2025.
  • Eligible dependent child(ren):
    — Does not need to be a full-time student
    — Is not required to live with you
    — Does not need to be an eligible dependent on the parent’s tax return
    — May be married or unmarried (your child’s spouse and children are not eligible)
  • Your unmarried children of any age who are permanently and totally disabled physically or mentally for whom you provide financial support. You must periodically provide medical documentation of such disability

Individuals Eligible for Medicare
If you have Medicare, or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please refer to the Notice of Creditable Coverage & Medicare Part D information located in the Legal Notices at www.srsbenefits.com.

Individuals Not Eligible for ShopRite Medical Coverage
If you have a qualifying event and are offered continued coverage through COBRA, you may want to consider buying an individual health insurance plan through your state’s Marketplace. The Marketplace may offer you additional choices to better fit your budget and needs.

Notify your Benefits Administrator if You Lose Medicaid/CHIP Eligibility
If you or your dependents lose eligibility for Medicaid or the Children’s Health Insurance Program (CHIP) coverage, or become eligible for a state’s premium assistance subsidy under Medicaid or CHIP, you will
have 60 days from the date of that Medicaid/eligibility change to request enrollment in a ShopRite medical plan. Please refer to the Legal Notices on this website for more details.

Individuals Planning to Retire or Leave ShopRite
If you are planning to retire, please contact your Benefits Specialist to discuss your benefit options. As an actively working associate and covered under the ShopRite Supermarkets, Inc. Benefit Plan, you are
primary under ShopRite Supermarkets, Inc.

Important Note: Remember to notify/enroll for Medicare two (2) months prior to your 65th birthday of your age regardless of retiring. Medicare will enforce penalties if you are not on a delayed enrollment.
As an active associate, if you or your spouse are eligible for Medicare (age 65), you continue to be eligible for ShopRite Supermarkets, Inc. benefits

What is a Qualifying Life Event?

After the Open Enrollment period ends, you cannot change your elections during the year unless you have a “qualified life event” and you notify your Benefits Specialist within 30 days of the event. Qualified Life Events (QLE) are defined by the IRS and include:

  • Marriage, divorce or legal separation
  • Birth or adoption of a child or placement of a child for adoption
  • Death of a dependent
  • Child is no longer eligible due to reaching limiting age
  • Change in spouse’s employment status that results in a gain or loss of coverage, such as beginning or terminating employment, or changing status from full-time to part-time

Important Note
If you experience any of the life events or if you have questions, please contact your Benefits Specialist.

  • If you change your medical plan election due to a qualified change life event, your deductibles and out-of-pocket maximums are also subject to change. For example, if you get married and add your spouse, you will change from Single to Family, and your deductibles and out-of-pocket maximums will increase.

Please contact your Benefits Specialist for more information about how this may impact you based on your current election and potential change.

EnglishenEnglishEnglish
EnglishenEnglishEnglishSpanishesSpanishEspañol