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OPEN ENROLLMENT / RE-ENROLLMENT AND BENEFITS CHANGE FORMPERALTA COMMUNITY COLLEGE DISTRICT BENEFITS OFFICE TH 333 East 8 Street Oakland, CA 94606 FOR RETIREES WITH A RETIREMENT EFFECTIVE DATE ON OR
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What is retiree open enrollment form?
Retiree open enrollment form is a document that retirees need to fill out to make changes to their benefits during the open enrollment period.
Who is required to file retiree open enrollment form?
Retirees who wish to make changes to their benefits during the open enrollment period are required to file the retiree open enrollment form.
How to fill out retiree open enrollment form?
To fill out the retiree open enrollment form, retirees need to provide their personal information, select the desired benefits changes, and submit the form before the deadline.
What is the purpose of retiree open enrollment form?
The purpose of the retiree open enrollment form is to allow retirees to make changes to their benefits for the upcoming year, such as adding or removing dependents, changing healthcare plans, or adjusting coverage levels.
What information must be reported on retiree open enrollment form?
The retiree open enrollment form typically requires retirees to provide their personal information, such as their name, address, contact details, and Social Security number. They may also need to report any changes to their dependents and select the desired benefits changes.
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