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Este formulario permite a los empleados de Genesee County inscribirse, cambiar o eliminar la cobertura del seguro de salud y bienestar.

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How to fill out 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM

01

Obtain the 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM.

02

Fill out your personal information at the top of the form, including name, address, and contact details.

03

Indicate whether you are enrolling, changing, or deleting insurance coverage.

04

Provide details of the current insurance plan you are enrolled in, if applicable.

05

If enrolling, select the coverage options you wish to opt for and provide any required details.

06

If changing or deleting, specify the changes and/or the members being deleted from the plan.

07

Double-check all information for accuracy and completeness.

08

Sign and date the form at the bottom.

09

Submit the completed form to the designated department or individual as instructed.

Who needs 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM?

01

Employees who are eligible for the water and waste insurance coverage offered by Genesee County.

02

Individuals who wish to change their current coverage or delete existing coverage.

03

New hires or those who are experiencing a qualifying event that allows for enrollment or changes.

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What is 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM?

The 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM is a document used by employees of Genesee County to enroll in, make changes to, or delete their water and waste insurance coverage for the specified period.

Who is required to file 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM?

Employees who wish to enroll in, change their existing coverage, or delete their water and waste insurance must file the form.

How to fill out 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM?

To fill out the form, employees must provide their personal information, details of the insurance coverage being requested or modified, and any relevant dates. It is important to follow the instructions provided on the form carefully.

What is the purpose of 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM?

The purpose of the form is to formally document the enrollment, changes, or deletions of water and waste insurance by employees, ensuring that all changes are recorded and processed accordingly.

What information must be reported on 2011-2012 UNION GENESEE COUNTY WATER AND WASTE INSURANCE ENROLLMENT/CHANGE/DELETION FORM?

The form must report personal identification details of the employee, specific details of the insurance coverage (including type and level of coverage), and any effective dates for the changes or enrollment.

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