Get the free Flexible Benefit Election Form 2009.doc - archstl

PLEASE COMPLETE THIS FORM ONLY IF YOU ELECT TO PARTICIPATE IN THE MEDICAL OR DEPENDENT REIMBURSEMENT PLANS OR INSURANCE PREMIUM PAYMENT WAIVER. Archdiocese of St Louis Employee Flexible Benefits Plan

How to fill out flexible benefit election form

How to fill out a flexible benefit election form:

1. Start by carefully reading the form and instructions provided. Make sure you understand the purpose of the form and the options available to you.
2. Provide your personal information accurately, including your full name, employee ID or social security number, and contact details.
3. Indicate the enrollment period for which you are making benefit elections.
4. Review the available benefit options and select the ones that are most suitable for your needs. This may include healthcare, dental, vision, life insurance, retirement plans, and other benefits offered by your employer.
5. Pay close attention to any documentation or proof required for certain benefits, such as marriage certificates or birth certificates for dependents.
6. Determine the coverage levels or contribution amounts based on your preferences and budget. Some benefits may offer different tiers or levels of coverage, so choose accordingly.
7. If you wish to decline or waive any benefits, clearly indicate it on the form.
8. Check for any signature or date requirements and provide them as necessary.
9. Attach any supporting documents required, such as dependent verification forms or documentation for medical conditions.
10. Review your choices and double-check for any errors or omissions before submitting the form.

Who needs a flexible benefit election form?

1. Employees who are eligible for benefits offered by their employer may need to complete a flexible benefit election form.
2. This form allows employees to choose the specific benefits they want to enroll in or make changes to their existing benefit selections.
3. It is important for employees to carefully consider their options and complete the form during the designated enrollment period to ensure they have the desired coverage and benefits in effect for the upcoming period.

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