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FLEXIBLE BENEFITS PLAN ELECTION FORM & COMPENSATION REDIRECTION AGREEMENT Company: ALL FIELDS ARE REQUIRED PLEASE PRINTToPLAN YEAR DATES:DIVISION: (if applicable) DOH EFF DATE SOCIAL SECURITY NUMBER:
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How to fill out flexible benefits plan election

01
Familiarize yourself with the available benefit options.
02
Understand the eligibility requirements and any limitations of the flexible benefits plan.
03
Determine the coverage and/or contribution amounts you need for each benefit option.
04
Calculate the costs associated with each benefit option.
05
Consult with a benefits specialist or human resources representative for guidance.
06
Complete the required forms or electronic enrollment process.
07
Review your choices before submitting the enrollment to ensure accuracy.
08
Keep a copy of your enrollment confirmation for future reference.

Who needs flexible benefits plan election?

01
Employees who have access to a flexible benefits plan offered by their employer.
02
Individuals who want more control and customization over their employee benefits.
03
People who have specific healthcare or financial needs that may require additional coverage or contributions.
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Flexible benefits plan election allows employees to choose the benefits that best suit their individual needs.
Employees who are eligible to participate in the flexible benefits plan are required to file their elections.
Employees can usually fill out their flexible benefits plan election forms online or through their HR department.
The purpose of flexible benefits plan election is to give employees the opportunity to customize their benefits package according to their preferences.
Employees must report their choices for health insurance, retirement savings plans, and other benefits offered by the employer.
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