Get the free Retiree Request for Change of Healthcare - ohr.psu.edu - ohr psu
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Retiree Request for Change of Healthcare **See reverse side regarding important information** Retiree Name Please Print / PSU ID # / (Date of Birth) Home Phone Home Address Eligible dependents are
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How to fill out retiree request for change
How to fill out retiree request for change:
01
Obtain the retiree request for change form, either online or from your employer's human resources department.
02
Fill out your personal information section, including your full name, contact information, and retiree identification number.
03
Specify the type of change you are requesting, such as a change in address, change in contact information, change in beneficiary, or change in health coverage.
04
Provide the necessary details requested for the specific change you are requesting. For example, if you are changing your address, provide your old address and the new address. If you are changing your contact information, provide your previous phone number or email and the updated one.
05
If you are requesting a change in beneficiary, provide the information of the new beneficiary, including their full name, relationship to you, and their contact information.
06
If you are requesting a change in health coverage, provide the necessary information regarding your new health insurance plan or any other relevant details.
07
Review the information you have provided to ensure accuracy and completeness.
08
Sign and date the retiree request for change form.
09
Submit the completed form to the designated department or office, as specified by your employer or the form instructions.
Who needs retiree request for change?
Retirees who need to update or make changes to their personal information, address, contact details, beneficiaries, or health coverage should fill out a retiree request for change form. This form ensures that any requested changes are properly recorded and implemented by the retiree's employer or retirement plan administrator. By submitting this form, retirees can ensure that their information is up to date and that any changes are reflected accurately in their retirement benefits and communications.
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What is retiree request for change?
Retiree request for change is a form used by retirees to make changes to their benefits or personal information.
Who is required to file retiree request for change?
Retirees who wish to make changes to their benefits or personal information are required to file a retiree request for change.
How to fill out retiree request for change?
Retirees can fill out the retiree request for change form by providing accurate and up-to-date information regarding their requested changes.
What is the purpose of retiree request for change?
The purpose of retiree request for change is to allow retirees to update their benefits or personal information as needed.
What information must be reported on retiree request for change?
Retirees must report accurate information about the changes they wish to make to their benefits or personal information on the retiree request for change form.
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