Coverage and Cost Information is posted at www.stlouiscountymn.gov/benefits

Spouse Life: You are the beneficiary, coverage is limited to half the amount you elect on yourself, amounts over $30,000 will require medical review/approval, if your spouse works for SLC/ARC you cannot enroll them in spousal life

Child Life: You are the beneficiary, coverage applies to all eligible children (under 18 or under 24 if full -time student)

Note: If your spouse works for SLC or ARC, you cannot enroll them in a benefit that they enrolled in themself

Note: If your child works for SLC or ARC, you cannot enroll them in a benefit that they enrolled in themself

You are not enrolled until you click SUBMIT and you have received confirmation at your work email.

I authorize my employer to deduct from my pay any contributions that may be required for the cost of enrolled coverage. By clicking the submit button, I certify that the information provided in this application is true and correct. I further understand that should any of my dependents at any time not meet the eligibility requirements, whether due to divorce or other reasons, I will inform the Human Resources Department within 30 days of an event which results in the loss of eligibility. I understand that St. Louis County may periodically ask for substantiation of dependent status, and that claims paid for ineligible dependents may be retroactively denied.