KS State Employee Health Plan (SEHP) Enrollment Form 2011-2026 free printable template

STATE EMPLOYEE HEALTH PLAN SEHP ENROLLMENT FORM PLEASE PRINT CLEARLY AND COMPLETE ENTIRE FORM EFFECTIVE DATE For HR Use ONLY EMPLOYEE ID STATE AGENCY NON STATE GROUP EMPLOYEE INFORMATION EMPLOYEE MUST COMPLETE EMPLOYEES AND SPOUSES AGE 65 AND OVER MUST ALSO COMPLETE THE HEALTH CARE SELECTION FORM. If enrolling in SEHP coverage I authorize the deduction from my earnings for the cost of coverage which I have selected. I understand that payment on a pretax basis means that my gross pay will be...

How to fill out KS State Employee Health Plan SEHP

How to fill out KS State Employee Health Plan (SEHP) Enrollment

1. Obtain the KS State Employee Health Plan (SEHP) Enrollment form from your agency or the official website.
2. Fill in your personal information, including your name, address, and contact details.
3. Provide your Social Security number and date of birth.
4. Indicate your employment status and select the coverage option you wish to enroll in.
5. List any dependents you wish to include under your plan, providing their details as required.
6. Review the plan options and select any additional coverage, if applicable.
7. Sign and date the enrollment form to confirm your application.
8. Submit the completed form to your HR department or the designated enrollment coordinator by the specified deadline.

Who needs KS State Employee Health Plan (SEHP) Enrollment?

1. All state employees who are eligible for health benefits through their employment with the state of Kansas.
2. Employees who wish to add or change their health insurance coverage.
3. New hires who need to enroll in health coverage during their initial enrollment period.
4. Employees experiencing qualifying life events such as marriage, birth of a child, or loss of other insurance coverage.

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What is KS State Employee Health Plan (SEHP) Enrollment?

KS State Employee Health Plan (SEHP) Enrollment is the process through which eligible Kansas state employees can enroll in health insurance plans offered by the state. This enrollment provides employees access to medical, dental, and vision coverage.

Who is required to file KS State Employee Health Plan (SEHP) Enrollment?

All eligible state employees who wish to participate in the health insurance plans must file KS State Employee Health Plan (SEHP) Enrollment. This includes full-time and part-time employees, as well as new hires and those experiencing qualifying life events.

How to fill out KS State Employee Health Plan (SEHP) Enrollment?

To fill out the KS State Employee Health Plan (SEHP) Enrollment, employees must complete the enrollment form either online or in paper format, providing necessary personal information, selecting their desired coverage options, and submitting the form within the enrollment period.

What is the purpose of KS State Employee Health Plan (SEHP) Enrollment?

The purpose of KS State Employee Health Plan (SEHP) Enrollment is to ensure that eligible state employees have access to health insurance coverage that meets their needs, promotes their well-being, and protects them against high medical costs.

What information must be reported on KS State Employee Health Plan (SEHP) Enrollment?

The KS State Employee Health Plan (SEHP) Enrollment requires reporting personal information such as the employee's name, date of birth, social security number, contact information, employment details, and selection of insurance coverage options.