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CITY OF SPOKANE FLEXIBLE BENEFIT PLAN HEALTH CARE AND DEPENDENT CARE ACCOUNT ENROLLMENT FORM Please Print or Type: FOR BENEFITS SECTION USE: EFFECTIVE DATE: Employee Name Last First MI Home Address
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How to fill out the enrollment form - instantbenefitsnet:

01
Visit the official website of instantbenefitsnet.
02
Locate the enrollment form on the website.
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Read the instructions provided on the form carefully.
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Begin by providing your personal information, such as your full name, date of birth, and contact details.
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Fill in the required fields for your address, including street, city, state, and zip code.
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Provide your social security number or any other identification number requested.
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If applicable, indicate your marital status and provide the necessary information for your spouse or dependents.
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Specify your employment details, including your occupation, employer's name, and contact information.
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Indicate the type of coverage or benefits you are enrolling for.
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If required, sign the form and include the date.
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Double-check all the information you have provided for accuracy.
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Submit the completed enrollment form through the designated method, such as online submission or mail.

Who needs the enrollment form - instantbenefitsnet:

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Employees who wish to enroll in the benefits program offered by their employer through instantbenefitsnet.
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Individuals who are starting a new job and need to provide their information and select their benefits.
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Current employees who want to make changes or updates to their existing benefits coverage.
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Dependents of employees who need to be added to the benefits program.
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Individuals who have experienced a qualifying life event, such as marriage, birth, or adoption, and need to adjust their benefits accordingly.
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Enrollment form - instantbenefitsnet is a document used to collect information from individuals who wish to enroll in benefits or services provided by instantbenefitsnet.
Individuals who want to enroll in benefits or services provided by instantbenefitsnet are required to file the enrollment form.
To fill out the enrollment form, individuals need to provide accurate information about themselves and their desired benefits or services.
The purpose of the enrollment form is to collect necessary information to process an individual's enrollment in benefits or services provided by instantbenefitsnet.
Information such as personal details, desired benefits or services, contact information, and any other relevant information must be reported on the enrollment form.
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