Oaceus 360 Program
Opt-Out Request
Participation in the Oaceus 360 program is voluntary. If you would like to opt out, please use the appropriate form below based on your situation. All opt-out requests must be submitted electronically. For detailed information about opt-out timelines and policies, visit our Opt-Out & Enrollment FAQ.
Opt-Out SRA Form
Use this form if you are within your first 30-day enrollment window or during the annual anniversary period. No documentation is required.
Submit Opt-Out SRA FormQualifying Life Event (QLE)
If you are past the 30-day enrollment window and need to opt out due to a qualifying life event, use the form below. Supporting documentation must be uploaded with your submission.
Examples of qualifying life events:
- Marriage or divorce
- Birth or adoption of a child
- Gain or loss of other coverage
- Change in employment status (hours reduced, job ended, new position)
- Change in residence or address
- Change in dependent eligibility
If you do not have documentation, you must have your HR department complete and sign the QLE Verification Form and upload the signed form using the submission button below.
Submit QLE Opt-Out FormOpt Back In
Previously opted out and want to rejoin? You may opt back in at any time. Once submitted and approved, the program will be added back into your payroll structure based on eligibility.
Submit Opt-In SRA FormFor Employers
If an employee sends you an opt-out request directly (by email or on paper), please either direct them to complete the appropriate form above, or submit it on their behalf using the applicable link and uploading their documentation.
Please Note
All opt-out requests must be submitted electronically through the forms on this page. This ensures accurate record-keeping across all participating employer groups. Requests sent by email will not be processed.
Need Help?
The Oaceus Benefits Team is available to assist you with opt-out requests, QLE submissions, enrollment status, and general benefit questions.