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2014 Enrollment Election and Change Form Retiree's Date of Retirement: Plant Retiree Retired From: Retiree/Surviving Spouse Information LAST NAME FIRST NAME M.I. GENDER M ADDRESS APT # CITY DATE OF
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Enrollment election and change is the process of choosing or changing your benefits or coverage options, such as health insurance, retirement plans, or flexible spending accounts.
Employees or individuals who are eligible for benefits or coverage options from their employer or organization.
Enrollment election and change forms are typically provided by the employer or organization, and individuals must follow the instructions provided to make their selections.
The purpose of enrollment election and change is to allow individuals to make informed decisions about their benefits and coverage options based on their personal circumstances and needs.
Individuals must report their personal information, such as name, address, and dependents, as well as their benefit and coverage selections.
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