Get the free 2016 ACTIVE ENROLLMENT FORMS Updated 9.21.2015 - memphistn

Nicotine Usage/Nonage Statement Active Employee The surcharge on the medical plan imposed for the use of Nicotine Products is $120 per month per family. To avoid the surcharge, covered participant

How to fill out 2016 active enrollment forms

How to fill out 2016 active enrollment forms:

1. Start by carefully reading the instructions provided with the forms. This will give you a better understanding of the information and documents required.
2. Begin with personal information such as your full name, address, contact details, and social security number. Double-check for accuracy to avoid any errors.
3. Next, provide information about your current healthcare coverage, if any. This may include details about your insurance provider and policy number.
4. Indicate whether you would like to make any changes to your current coverage or if you are applying for new coverage altogether.
5. If you are choosing a new healthcare plan, carefully review the available options and select the one that best suits your needs. Consider factors such as premium costs, deductibles, co-pays, and networks of healthcare providers.
6. Make sure to include information about any dependents or family members who will also be covered under your healthcare plan. Include their names, social security numbers, and relationship to you.
7. If you have any specific medical conditions or need assistance with certain healthcare services, make sure to provide that information in the appropriate section of the form.
8. Lastly, review the completed form to ensure accuracy and completeness. Sign and date the form before submitting it according to the provided instructions.

Who needs 2016 active enrollment forms:

1. Individuals who currently have healthcare coverage but wish to make changes to their existing plan for the upcoming year may need to fill out 2016 active enrollment forms.
2. Those who are currently uninsured and looking to obtain healthcare coverage for the year 2016 will also need to fill out active enrollment forms.
3. Individuals who have experienced qualifying life events such as marriage, divorce, or the birth of a child, may need to update their healthcare coverage and thus require 2016 active enrollment forms.

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