Get the free MESSA Status Change Form - CMich.edu
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1475 Kendall Blvd., PO Box 2560
East Lansing, MI 488262560
800.292.4910Employee Personal Status Change Form
Use to add or delete dependents, change address, and/or to delete options. Please fill out
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How to fill out messa status change form
How to fill out messa status change form
01
To fill out the messa status change form, follow these steps:
1. Obtain the messa status change form from your employer or download it from the messa website.
02
Fill in your personal information, including your name, address, and contact details.
03
Provide your current messa status, such as Active, Retired, or On Leave.
04
Indicate the effective date of the status change.
05
If applicable, provide any supporting documentation for the status change, such as a letter from your employer or a medical certificate.
06
Review the completed form for accuracy and make any necessary corrections.
07
Sign and date the form.
08
Submit the form to the appropriate authority, such as your employer's HR department or the messa administration.
09
Keep a copy of the filled form for your records.
Who needs messa status change form?
01
Anyone who requires a change in their messa status needs to fill out the messa status change form. This form is typically used by employees, retirees, or individuals on leave who experience a change in their messa enrollment status. It is important to submit this form to ensure accurate messa coverage and benefits.
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