Get the free STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010 - hr sta...
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This document is a form for retirees to select their benefits options including medical, dental, and vision plans for the year 2009-2010. It also collects personal information and allows for changes
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How to fill out STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010
01
Obtain the STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010 from the official website or human resources department.
02
Read the instructions carefully on the first page of the form.
03
Fill in your personal information, including your full name, address, and contact details.
04
Indicate your retirement benefits eligibility status.
05
Review the various benefit options available for retirees and LTD participants.
06
Check the boxes for the benefits you wish to enroll in or make changes to.
07
If applicable, provide information about any dependents covered under your benefits.
08
Calculate and confirm any required contributions or premiums for selected options.
09
Sign and date the form at the designated section.
10
Submit the completed form to your human resources department by the specified deadline.
Who needs STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010?
01
Retired employees of the state of Arizona who are eligible for benefit options.
02
Individuals who are enrolled in Long-Term Disability (LTD) programs offered by Arizona.
03
Beneficiaries or dependents of retirees and LTD participants who may need to make changes to their coverage.
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What is STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010?
The STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010 is a document used by retirees and long-term disability (LTD) recipients in Arizona to enroll in or make changes to their benefit options during the designated open enrollment period for that fiscal year.
Who is required to file STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010?
Retirees and individuals currently receiving long-term disability benefits from the State of Arizona are required to file the form during the open enrollment period to select or modify their health and other insurance benefits.
How to fill out STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010?
To fill out the form, individuals should carefully read the instructions provided, enter personal information such as name and identification number, select their desired benefit options, and submit the completed form by the deadline specified in the enrollment guidelines.
What is the purpose of STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010?
The purpose of the form is to allow eligible retirees and LTD recipients to choose or update their benefits each year, ensuring they have access to the necessary health insurance and other benefits that suit their needs.
What information must be reported on STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD OPEN ENROLLMENT FORM 2009-2010?
Required information includes the individual's personal details, information about their current benefits, choices for new or changed benefits, and any dependent information that may be relevant for coverage purposes.
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