Get the free CalPERS HEALTH BENEFITS RETIREE ENROLLMENT FORM C - fhdafiles fhda

Callers HEALTH BENEFITS RETIREE ENROLLMENT FORM C TO ENROLL, COMPLETE AND RETURN THIS FORM TO: Health Account Services P.O. Box 942714, Sacramento, CA 94229-2714 OR SUBMIT BY FAX: (916) 795-1313 Member

How to fill out calpers health benefits retiree

How to fill out CalPERS health benefits retiree:

1. First, gather all the necessary information and documents such as your retirement date, social security number, and any other relevant identification.
2. Visit the CalPERS website and navigate to the retiree health benefits section.
3. Find the retiree health benefits application form and download it.
4. Carefully read the instructions before filling out the form to ensure you understand the process and requirements.
5. Begin by providing your personal information, including your name, address, and contact details.
6. Fill in your retirement date and any other details requested regarding your retirement from a CalPERS-covered position.
7. Provide your social security number and any other identification information requested.
8. Next, indicate the type of coverage you are seeking, such as medical, dental, or vision.
9. If you have eligible dependents, provide their information as well, including their names, dates of birth, and relationship to you.
10. Review the form thoroughly to make sure all the information is accurate and complete. Any mistakes or missing information can delay the application process.
11. Once you are satisfied with the form, sign and date it as required.
12. Make a copy of the completed application for your records.
13. Submit the application either online or by mail, following the instructions provided by CalPERS.
14. If necessary, include any supporting documents, such as proof of eligibility for dependent coverage.
15. Keep track of your application status through the CalPERS website or by contacting their customer service.

Who needs CalPERS health benefits retiree?

1. Retired individuals who were enrolled in CalPERS health benefits during their active employment.
2. Spouses or domestic partners of retired individuals who were enrolled in CalPERS health benefits during their active employment.
3. Eligible dependents of retired individuals who were enrolled in CalPERS health benefits during their active employment.

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