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This document provides an overview of the Commonwealth of Virginia’s State Health Benefits Program, outlining eligibility, election choices, and enrollment information for employees.
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How to fill out state health benefits program

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How to fill out State Health Benefits Program Eligibility and Enrollment Information For Employees

01
Obtain the 'State Health Benefits Program Eligibility and Enrollment Information For Employees' form from your HR department or the official state website.
02
Carefully read the instructions provided at the top of the form to understand eligibility requirements.
03
Fill out your personal information, including your name, employee ID, and contact details.
04
Indicate your employment status, such as full-time or part-time.
05
List any dependents you wish to enroll in the health benefits program, providing their names and dates of birth.
06
Select the health plan options available to you, making sure to review the benefits and costs associated with each plan.
07
Sign and date the form to confirm that all information is accurate and complete.
08
Submit the completed form to your HR department by the deadline specified.

Who needs State Health Benefits Program Eligibility and Enrollment Information For Employees?

01
Employees of the state seeking to enroll in or update their health benefits.
02
Individuals looking to add qualified dependents to their health coverage.
03
New hires who are eligible for health benefits.
04
Current employees experiencing a qualifying life event that affects their health benefits eligibility.
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People Also Ask about

Health Insurance Benefits Hospital care. Visits to a primary care doctor and specialists. Outpatient procedures, like surgery. Laboratory tests and diagnostic services, like x-rays and mammograms. Pregnancy and newborn care. Preventive and routine care, like vaccinations and checkups. Mental health care.
Eligible Dependents Your dependent children up to age 26, who are (1) a natural or legally adopted child of the subscriber, (2) foster child of the subscriber, (3) a child for which the subscriber is a court-appointed guardian, or (4) stepchild of a member who is married to the stepchild's natural parent.
Who is eligible for N.C. Health Choice for Children? Family SizeAnnual IncomeMonthly Income 1 $22,980 $1,915 2 $31,020 $2,585 3 $39,060 $3,255 4 $47,100 $3,9255 more rows
State Health Benefits Program State Employees — To be eligible, you must be a full-time employee of the State of New Jersey or be a full-time appointed or elected officer of the State (this includes employees of a State agency or authority and employees of a State college or university).
How to get or stay on a parent's plan. If a parent's health insurance plan covers dependents, you usually can be added to their plan and stay on it until you turn 26.
Eligible Dependents Spouse. Your dependent children up to age 26, who are (1) a natural or legally adopted child of the subscriber, (2) foster child of the subscriber, (3) a child for which the subscriber is a court-appointed guardian, or (4) stepchild of a member who is married to the stepchild's natural parent.
ACA Rules on Employer-Sponsored Health Insurance Under the ACA, employers with 50 or more full-time employees (or the equivalent in part-time employees) must provide health insurance to 95% of their full-time employees or pay a penalty to the IRS. This penalty is quite hefty — $4,460 per employee per year (in 2024).
The Plan provides health care coverage to nearly 750,000 teachers, state employees, retirees and their dependents.

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The State Health Benefits Program Eligibility and Enrollment Information for Employees provides guidelines and requirements for employees to determine their eligibility for health benefits and the process for enrolling in health insurance plans offered by the state.
Employees who wish to enroll in or make changes to their health benefits under the State Health Benefits Program are required to file the Eligibility and Enrollment Information. This includes new employees, those changing their status, or individuals experiencing qualifying life events.
To fill out the State Health Benefits Program Eligibility and Enrollment Information, employees must provide personal information such as their name, social security number, employment details, and information about dependents if applicable. They should follow the instructions provided on the form to ensure accurate completion.
The purpose of the State Health Benefits Program Eligibility and Enrollment Information is to collect necessary information from employees to assess their eligibility for the health benefits program and to facilitate their enrollment in the available health insurance plans.
Employees must report information such as their personal details (name, address, employee ID), social security number, date of birth, employment status, type of coverage desired, and any dependent information, including names and dates of birth of dependents that may be included in the health plan.
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