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This form is used for enrolling in health benefit plans for retirees or participants in Long-Term Disability (LTD) through the State of Arizona, allowing selection of medical, dental, and vision coverage,
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How to fill out STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM
01
Start by downloading the STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM from the official website.
02
Fill in your personal information in the designated sections, including your full name, address, and contact information.
03
Indicate your Social Security Number clearly in the required field.
04
Provide details regarding your retirement date and any prior employment details required.
05
Choose the types of benefits you wish to enroll in, such as health insurance, dental, or vision coverage.
06
Review the eligibility requirements for each benefit option and ensure you meet the criteria.
07
If applicable, list any dependents you wish to include in your benefits plan.
08
Read the enrollment instructions and terms carefully before proceeding.
09
Sign and date the form at the designated area to validate your enrollment.
10
Submit the completed form by the specified deadline through the provided submission method (mail, fax, or online).
Who needs STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM?
01
Retired employees of the State of Arizona who wish to enroll in benefit options.
02
Individuals who are on Long-Term Disability (LTD) and need to select their benefits.
03
Any qualifying spouse or dependent of a retiree who needs to be included in the health benefit plans.
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People Also Ask about
How many years do you have to work for the state of Arizona to retire?
At age 65; or • At age 62 with 10 or more years of credited service; or • At any combination of years of credited service and age totaling 80 points. If you are at least 50 years of age and have five or more years of credited service, you are eligible for early retirement.
What is the phone number for American Airlines retirees?
You can enroll in retiree medical coverage any time after retirement, up to the age of 65. Call the Benefits Service Center at 888-860-6178 if you miss the annual online retiree medical enrollment window. American reserves the right to amend or terminate the retiree medical plan at any time.
How many years do you have to work for the state of AZ to retire?
At age 65; or • At age 62 with 10 or more years of credited service; or • At any combination of years of credited service and age totaling 80 points.
What is the phone number for the security benefit annuity?
You can reach Security Benefit by calling 785.438. 3000 or 800.888. 2461, 8 a.m. to 7 p.m. (Eastern Time), Monday through Friday.
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What is STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM?
The STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM is a document used for enrolling retirees in benefit programs provided by the state, specifically focusing on Long-Term Disability (LTD) options for the year 2011.
Who is required to file STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM?
Individuals who are retiring from employment with the State of Arizona and wish to enroll in the benefit options related to retirement and long-term disability are required to file this form.
How to fill out STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM?
To fill out the form, carefully read the instructions, provide personal identification information, select the desired benefit options, and ensure all relevant sections are completed before submitting it to the appropriate department.
What is the purpose of STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM?
The purpose of the form is to facilitate the enrollment of eligible retirees in benefit plans that provide long-term disability coverage and other retirement benefits as outlined by the State of Arizona.
What information must be reported on STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD 2011 ENROLLMENT FORM?
The form requires reporting personal details such as name, address, social security number, employment history, and choices regarding specific benefit options available under the retirement plan.
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