
Get the free Group Health Plan Enrollment Request Form - rit.edu
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2017 Medicare Blue PPO Group Health Plan Enrollment Request Form Return Applications to: Department of Human Resources Rochester Institute of Technology George Eastman Hall, 5th floor 8 Bomb Memorial
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How to fill out group health plan enrollment

How to fill out group health plan enrollment
01
Read the instructions provided by your employer or insurance provider.
02
Gather all the necessary personal and dependent information.
03
Complete the enrollment form accurately and legibly.
04
Provide all required supporting documentation, such as proof of dependent eligibility.
05
Review the options available in the group health plan and choose the coverage that best suits your needs.
06
Consider any additional benefits or optional coverage offered and make your selections accordingly.
07
Submit the completed enrollment form and supporting documents before the deadline specified by your employer or insurance provider.
08
Keep a copy of the filled-out enrollment form and any other relevant documentation for your records.
09
Contact the appropriate representative if you have any questions or need further assistance.
Who needs group health plan enrollment?
01
Employees who are eligible for their employer's group health plan.
02
Employers who want to provide health insurance coverage to their employees.
03
Dependents who rely on the employee for health insurance coverage.
04
Small businesses looking to offer affordable health insurance options to their employees.
05
Organizations or associations that want to provide a group health plan to their members.
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