Get the free Retiree Open Enrollment Form - City of Sacramento

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Sacramento State Open Enrollment WorksheetSubmit to the Benefits Office in Del Norte Hall 3004 by 5:00 P.M. on Friday, October 4, 2019. Effective date: January 1, 2020, Employee InformationEmployee

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What is retiree open enrollment form?

Retiree open enrollment form is a form that retirees need to fill out to make changes to their health insurance coverage during the open enrollment period.

Who is required to file retiree open enrollment form?

Retirees who are looking to make changes to their health insurance coverage are required to file the retiree open enrollment form.

How to fill out retiree open enrollment form?

Retirees can fill out the retiree open enrollment form online or by contacting their health insurance provider for assistance.

What is the purpose of retiree open enrollment form?

The purpose of retiree open enrollment form is to allow retirees to make changes to their health insurance coverage during the open enrollment period.

What information must be reported on retiree open enrollment form?

Retirees must report their personal information, any dependents they wish to add or remove from their coverage, as well as any changes to their coverage preferences.

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