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ENROLLMENT, CHANGE, CANCELLATION, OR OPT OUT EMPLOYEES ONLY HEALTH AND WELFARE PLANS (eff 08/2013) Lawrence Livermore National Security, LLC (LENS) Human Resources and Benefits Fill in all pertinent

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What is enrollment change cancellation or?

Enrollment change cancellation or is the process of cancelling changes made to enrollment in a program or service.

Who is required to file enrollment change cancellation or?

Individuals who have made changes to their enrollment status and wish to cancel those changes are required to file enrollment change cancellation or.

How to fill out enrollment change cancellation or?

To fill out enrollment change cancellation or, individuals typically need to provide their personal information, details of the enrollment changes, and a reason for cancellation.

What is the purpose of enrollment change cancellation or?

The purpose of enrollment change cancellation or is to revert back to the original enrollment status before any changes were made.

What information must be reported on enrollment change cancellation or?

Information such as name, ID number, program/service enrolled in, details of changes made, and reason for cancellation must be reported on enrollment change cancellation or.

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