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Benefits Enrollment2017 StaffWELCOME TO 2017 OPEN Enrollment are pleased to continue to offer eligible employees and their dependents a robust benefits program for 2017. The information in this document

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How to fill out benefi ts enrollment

01

Step 1: Obtain the benefits enrollment form from your employer or benefits provider.

02

Step 2: Read the instructions provided on the form carefully.

03

Step 3: Fill out your personal information accurately, including your full name, address, and contact details.

04

Step 4: Provide any necessary information regarding your dependents, such as their names, dates of birth, and relationships to you.

05

Step 5: Review the available benefit options and choose the ones that best suit your needs.

06

Step 6: Indicate the coverage levels you want for each selected benefit.

07

Step 7: Sign and date the form to indicate your agreement with the information provided.

08

Step 8: Submit the completed form to the designated person or department as instructed.

Who needs benefi ts enrollment?

01

Anyone who is eligible for benefits offered by their employer or benefits provider needs to complete the benefits enrollment process. This includes employees who are new to the organization, employees who have experienced a qualifying event such as marriage or the birth of a child, and employees who wish to make changes to their current benefit selections during the open enrollment period.

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