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OPEN ENROLLMENT 201617 P.O. Box 21367 Billings, MT 591041367 Phone # 8007773575 or 4062453575 Company Names: Descartes County/COMIC Group # 0000917 This Section Is To Be Completed By Employee Marital
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How to fill out deschutes county enrollment formdoc
How to fill out Deschutes County Enrollment Formdoc:
01
Begin by carefully reading the instructions provided on the form. These instructions will guide you through the process of filling out the form correctly.
02
Provide your personal information such as your full name, address, phone number, and email address in the designated sections of the form.
03
Indicate your enrollment type on the form. This could be for an individual, family, or group enrollment.
04
Specify the effective date of your enrollment. This is the date from which your coverage will start.
05
If you have any dependents who will be included in the enrollment, provide their names, dates of birth, and relationship to you.
06
Choose the appropriate coverage type for your enrollment. This could include options such as medical, dental, vision, or a combination of these.
07
If you have any specific coverage preferences or requirements, make sure to indicate them on the form.
08
Review the completed form for any errors or missing information before submitting it.
09
Sign and date the form to certify that the information provided is accurate.
10
Submit the filled-out form according to the instructions given. This may involve mailing or submitting it electronically.
Who needs Deschutes County Enrollment Formdoc:
01
Individuals who are residents of Deschutes County and want to enroll in health insurance coverage.
02
Families or groups residing in Deschutes County who wish to enroll in health insurance coverage together.
03
Those who are eligible for coverage through specific programs or organizations that require the completion of the Deschutes County Enrollment Formdoc.
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