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NAME BENEFIT ELECTION FORM DEPARTMENT For the 2016 Dental & Vision Plan Year EMPLOYEE NUMBER January 1, 2016, through December 31, 2016, DEDUCTIONS BEGIN DECEMBER 2015 Complete this form and return
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What is the name of the benefit election form?
The name of the benefit election form is usually specified by the employer or the benefits administrator.
Who is required to file the name of the benefit election form?
Employees who are eligible for benefits may be required to file the benefit election form.
How to fill out the name of the benefit election form?
The benefit election form can typically be filled out either online, through a paper form, or through a benefits administration portal.
What is the purpose of the name of the benefit election form?
The purpose of the benefit election form is to allow employees to choose their benefits options and make any necessary selections or changes.
What information must be reported on the name of the benefit election form?
The benefit election form may require information such as personal details, dependent information, and benefit selections.
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