Get the free Princeton Health Care Plan Election Form for Retirees Under Age 65 - princeton

This document is used by retirees under age 65 to elect their health care and vision plan coverage through Princeton University, including options for dependents.

How to fill out princeton health care plan

How to fill out Princeton Health Care Plan Election Form for Retirees Under Age 65

1. Obtain the Princeton Health Care Plan Election Form for Retirees Under Age 65 from the official website or HR department.
2. Read the instructions carefully before filling out the form.
3. Fill in your personal information, including your name, address, and Social Security number.
4. Indicate your retirement date and the effective date you want the health care plan to start.
5. Select the health care options you desire by checking the appropriate boxes.
6. Provide information about any dependent or spouse who will also be covered under the plan.
7. Review your selections to ensure accuracy and completeness.
8. Sign and date the form at the designated section.
9. Submit the completed form through the specified method (mail, email, or in-person).

Who needs Princeton Health Care Plan Election Form for Retirees Under Age 65?

1. Retirees under the age of 65 who are eligible for health care benefits offered by Princeton.
2. Individuals who wish to enroll in or make changes to their health care coverage upon retirement.

For pdfFiller’s FAQs

What is Princeton Health Care Plan Election Form for Retirees Under Age 65?

The Princeton Health Care Plan Election Form for Retirees Under Age 65 is a document that allows eligible retirees under the age of 65 to enroll in or modify their health care plan offerings, ensuring they have access to the necessary medical coverage after retirement.

Who is required to file Princeton Health Care Plan Election Form for Retirees Under Age 65?

Retirees under the age of 65 who wish to enroll in or change their health care coverage must file the Princeton Health Care Plan Election Form. This includes those who are newly retired or those who are making changes to their existing coverage.

How to fill out Princeton Health Care Plan Election Form for Retirees Under Age 65?

To fill out the Princeton Health Care Plan Election Form, retirees should provide their personal information, including name, address, and retirement date, select the desired health care plan options, and sign the form to certify the information is accurate before submitting it by the specified deadline.

What is the purpose of Princeton Health Care Plan Election Form for Retirees Under Age 65?

The purpose of the Princeton Health Care Plan Election Form for Retirees Under Age 65 is to facilitate the enrollment process for health care coverage, allowing retirees to choose the plan that best suits their needs and to maintain access to health services after leaving active employment.

What information must be reported on Princeton Health Care Plan Election Form for Retirees Under Age 65?

The form requires personal information such as the retiree's name, address, and retirement date, as well as details regarding the selected health care plan, including any dependents to be covered and any changes to current coverage options.