Get the free Form 23: Health Election Change Form for the - State of Oklahoma - ok
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Print Form Reset Form Oklahoma Firefighters Pension and Retirement System 4545 N. Lincoln Blvd., Suite 265 Oklahoma City, Oklahoma 73105-3407 1-800-525-7461 (405) 522-4600 Fax (405) 522-4643 www.okfirepen.state.ok.us
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What is form 23 health election?
Form 23 health election is a form used to select health insurance options offered by an employer or government organization.
Who is required to file form 23 health election?
Employees who are eligible for health insurance benefits and wish to enroll or make changes to their existing coverage are required to file form 23 health election.
How to fill out form 23 health election?
To fill out form 23 health election, the employee needs to provide personal information, select the desired health insurance plan, indicate the coverage level, and designate any dependents for coverage.
What is the purpose of form 23 health election?
The purpose of form 23 health election is to allow employees to choose and enroll in health insurance plans provided by their employers or government organizations.
What information must be reported on form 23 health election?
Form 23 health election requires personal information (name, address, social security number), health insurance plan selection, coverage level, and information about any dependents for coverage.
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