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Employee Benefits
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U.S. Workers
Please notify Employee Benefits of changes to your basic contact information through the form below. Do not contact Highmark or Meritain (formerly CBSA) with these changes. Do not use this form for Qualifying Changes.*
Participant’s Name
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Please Update my:
 eMail Mailing Address Phone
Cell Phone Fax
Current eMail
New eMail
New Mailing Address
New Phone
New Cell Phone
New Fax
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For U.S. Employees Only:
Employer’s Name
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(must check) 		By using this form, I certify that I am still employed by the same C&MA employer, and still paid to work 28 hrs/wk or more. I understand that my benefits may end if this job ends, if I go on leave of absence, if I change to another C&MA church, or if my hours reduce to less than 28 hours per week. If any of those changes occur, I will notify the C&MA Office of Employee Benefits within 30 days.
 
*Qualifying Changes to your Coverage
You must notify the Office of Employee Benefits via email or phone within 30 days of qualifying changes that could affect your coverage. Do not contact Highmark or Meritain (formerly CBSA) with these changes.
Qualifying changes include (but are not limited to):
• Changes to employment with the Alliance
• Adding or dropping a spouse/dependent under your plan
• Changes to dependent’s student status
• Eligibility for Medicare/Medicaid coverage (yourself or spouse)
Your benefits are tied to the employer/employee relationship. If your change is not shown in the above examples, please contact us. You may be legally liable for benefits received while you were not eligible.
Office of Employee Benefits
PO Box 35690, Colorado Springs, CO 80935-3569
Toll Free (800) 700-2651
FAX (719) 262-5397
E-mail: benefits@cmalliance.org