Coverage Change — Lose Other Coverage
You may want to:
- Enroll in coverage through Publix for you, your spouse and any dependents.
- Add your spouse and any dependents to your coverage.
Supporting documentation to submit
- A letter from the former insurance company indicating the date the insurance was canceled and for whom coverage was canceled
- Universal Enrollment/Change Form (Health, Dental or Vision)
- Disability Enrollment/Change Form (Short-Term Disability or Long-Term Disability)
- Tobacco Usage Affidavit
- A state or county certified marriage certificate (Note: A marriage license is not sufficient.)
- A state or county certified birth certificate or adoption papers for dependents
When to submit supporting documentation
Send to the Publix group benefits department by interoffice mail or fax to (863) 413-5771 within 30 days of the date the insurance was canceled.
The information provided on this website is intended to assist associates in understanding Publix's benefits. The information is in summary form and does not cover all details of the benefits. For specific benefit details, please see Your Associate Handbook or the Benefits Plan Documents. If there is a conflict between the information on this website and the contents of the handbook or plan documents, the terms of the handbook or plan documents control.
