Get the free SHBP Enrollment Form

SEAFARERSHEALTHANDBENEFITSPLAN 45353 Saint Georges Avenue Pinpoint,MD20674 P:(800)2524674(Option3) F:(301)9940116www.seafarers.orgENROLLMENTFORM This form must be completed and returned to the Seafarers

How to fill out shbp enrollment form

How to fill out shbp enrollment form

1. To fill out the SHBP enrollment form, follow these steps:
2. Obtain the SHBP enrollment form from your employer or the SHBP website.
3. Provide your personal information, including your full name, address, and contact details.
4. Indicate your employment status and employer information.
5. Choose the appropriate SHBP plan option that best suits your needs.
6. Provide information about your dependents, if applicable, including their names and relationship to you.
7. If enrolling in a dental or vision plan, select the desired options and provide any additional information required.
8. Review the form for accuracy and completeness.
9. Sign and date the enrollment form.
10. Submit the completed form to your employer or the designated SHBP enrollment office.

Who needs shbp enrollment form?

1. Employees who are eligible for the State Health Benefit Plan (SHBP) need to fill out the SHBP enrollment form. This includes
2. - Government employees
3. - Teachers and school employees
4. - State university and college employees
5. - Retired state employees
6. - Employees of participating local government agencies
7. These individuals need to submit the form to enroll in the SHBP and receive health insurance benefits.

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What is shbp enrollment form?

The shbp enrollment form is a form used to enroll in the State Health Benefits Program.

Who is required to file shbp enrollment form?

All eligible employees who wish to enroll in the State Health Benefits Program are required to file the shbp enrollment form.

How to fill out shbp enrollment form?

To fill out the shbp enrollment form, you need to provide personal information, select a health plan option, and submit the form to the designated HR or benefits office.

What is the purpose of shbp enrollment form?

The purpose of the shbp enrollment form is to collect information from eligible employees who wish to enroll in the State Health Benefits Program.

What information must be reported on shbp enrollment form?

The shbp enrollment form typically requires information such as name, address, social security number, dependent information, and health plan selection.