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This form is used for enrollment in the Long Term Disability Insurance Plan for non-exempt employees at the Tennessee Board of Regents, including options for new hire enrollment and coverage changes.
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How to fill out Tennessee Board of Regents Long Term Disability Insurance Plan Non-Exempt Enrollment Form

01
Obtain the Tennessee Board of Regents Long Term Disability Insurance Plan Non-Exempt Enrollment Form.
02
Fill out your personal information at the top of the form, including your name, address, and employee identification number.
03
Indicate your employment status and the department you work in.
04
Review the eligibility criteria and ensure that you qualify for enrollment in the plan.
05
Select the coverage options that best fit your needs and circumstances.
06
Sign and date the form to certify that all information provided is accurate.
07
Submit the completed form to your HR department or the designated benefits coordinator.

Who needs Tennessee Board of Regents Long Term Disability Insurance Plan Non-Exempt Enrollment Form?

01
Employees of the Tennessee Board of Regents who are non-exempt and wish to enroll in the Long Term Disability Insurance Plan.
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The Tennessee Board of Regents Long Term Disability Insurance Plan Non-Exempt Enrollment Form is a document that allows eligible employees to enroll in the Long Term Disability Insurance Plan, providing financial protection in case of a long-term illness or disability.
Employees classified as non-exempt under the Tennessee Board of Regents guidelines who wish to participate in the Long Term Disability Insurance Plan are required to file this form.
To fill out the form, employees need to provide personal information such as name, employee ID, position, and other relevant contact details, followed by selecting their participation options as outlined in the form's instructions.
The purpose of the form is to facilitate the enrollment of eligible non-exempt employees into the Long Term Disability Insurance Plan, ensuring they have access to benefits in the event of prolonged disability.
The form requires reporting of the employee's name, employee identification number, job title, department, date of birth, contact information, and any options for coverage selected or declined.
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