Get the free SISC Plan Election Form 2012-13 - Special Open ... - Cabrillo College - cabrillo

Cabrillo College Special Open Enrollment Plan Election Form Employees may choose between three (3) Blue Shield PPO plans and two (2) Blue Shield HMO plans offered through Self Insured Schools of California

How to fill out sisc plan election form

How to fill out sisc plan election form:

1. Start by carefully reading the instructions provided with the form. Make sure you understand the purpose of the form and the information it requires.
2. Begin by providing your personal information, such as your name, address, and contact details. It is essential to ensure the accuracy of this information.
3. Next, indicate your enrollment status and the type of coverage you are electing. This may include choosing between different healthcare plans offered by SISC (Self Insured Schools of California) or selecting the coverage level (e.g., individual or family).
4. If you have eligible dependents, provide their names and relevant details. For instance, if you are selecting coverage for your spouse or children, indicate their names and any other information requested.
5. Take note of any optional coverage choices available, such as dental or vision plans. If applicable, select the desired coverage options and provide the necessary details.
6. Review your selections and ensure all the information provided is accurate and complete. Make any necessary corrections or additions before submitting the form.

Who needs sisc plan election form:

1. Employees of school districts or educational institutions that participate in the Self Insured Schools of California (SISC) program may need to fill out the SISC plan election form. This form allows them to choose their healthcare coverage options.
2. Eligible dependents of these employees may also need to be included in the form. This may include spouses, children, or other dependents who are eligible for coverage under the SISC program.
3. It is important to consult with your employer or human resources department to determine if you need to fill out the SISC plan election form. They will be able to provide you with the specific requirements and deadlines for submitting the form.

For pdfFiller’s FAQs

What is sisc plan election form?

The sisc plan election form is a form used to make elections regarding a supplemental income security program.

Who is required to file sisc plan election form?

All employees eligible to participate in the supplemental income security program are required to file the sisc plan election form.

How to fill out sisc plan election form?

The sisc plan election form can be filled out by providing personal information, making elections regarding contribution levels and beneficiary designations, and signing the form.

What is the purpose of sisc plan election form?

The purpose of the sisc plan election form is to allow employees to make decisions regarding their participation in the supplemental income security program.

What information must be reported on sisc plan election form?

The sisc plan election form must include personal information, contribution elections, beneficiary designations, and signature of the employee.

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