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Health Benefits Election Form
Effective changes will take place on July 1, 2016,
Selection Form must be returned to Human Resources by Friday, June 3, 2016.
Medical Coverage Type and Premium Selection
Southern
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What is health benefits election form?
Health benefits election form is a form used by employees to choose their health insurance coverage options.
Who is required to file health benefits election form?
All eligible employees who want to enroll in or make changes to their health insurance coverage are required to file a health benefits election form.
How to fill out health benefits election form?
Employees must carefully review the options available, choose the best coverage for their needs, and complete the form accurately with all required information.
What is the purpose of health benefits election form?
The purpose of health benefits election form is to allow employees to select the health insurance coverage that best fits their needs and preferences.
What information must be reported on health benefits election form?
Employee personal information, dependent information, selected coverage options, and any additional requested details must be reported on the health benefits election form.
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