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CES Open Enrollment 11/1/17 11/30/17Health Savings Account (HSA) Enrollment Form (ONLY FOR THOSE ENROLLING IN THE HEALTH SAVINGS PLAN) (PLEASE PRINT FIRMLY USE BALL POINT PEN)Section 1: EMPLOYEE INFORMATION
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Gather all necessary documents and information such as social security number, birthdate, and income information.
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Fill out the open enrollment form accurately and completely.
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Open enrollment 11117 113017 refers to a specific period during which individuals can enroll in or make changes to their health insurance plans without facing penalties.
Individuals who are eligible for health insurance coverage, including employees and their dependents, are required to file for open enrollment 11117 113017.
To fill out open enrollment 11117 113017, individuals must complete the designated enrollment forms provided by their insurance provider or employer and submit them during the open enrollment period.
The purpose of open enrollment 11117 113017 is to allow individuals to review their current health insurance options and make necessary changes, such as switching plans or adding dependents.
Information that must be reported includes personal details such as name, address, and date of birth, as well as details about the health plan options being selected.
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