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2017 PLAN ELECTION FORM
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How to fill out 2017 plan election form
How to fill out 2017 plan election form
01
Step 1: Obtain a copy of the 2017 plan election form from your employer or insurance provider.
02
Step 2: Read the instructions and familiarize yourself with the sections and requirements of the form.
03
Step 3: Provide your personal information such as full name, address, date of birth, and social security number.
04
Step 4: Indicate your enrollment preference by choosing the desired plan and coverage options offered for 2017.
05
Step 5: If applicable, include information about your dependents and their coverage preferences.
06
Step 6: Review and double-check all the information you have provided to ensure accuracy.
07
Step 7: Sign and date the form to confirm your understanding and agreement with the choices you have made.
08
Step 8: Submit the completed form to your employer or insurance provider within the specified deadline.
Who needs 2017 plan election form?
01
Employees who are eligible for company-sponsored health insurance plans.
02
Individuals who want to make changes to their existing 2017 plan or enroll in a new plan.
03
Dependents of eligible employees who require coverage.
04
Anyone who wants to ensure they have proper health insurance for the year 2017.
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