Get the free Benefit Change Request Form (MERIT) - University of Iowa

THE UNIVERSITY OF IOWA BENEFIT CHANGE REQUEST FOR MERIT STAFF Employee Name (please print) ID # (use Employee ID or University ID#) If you wish to modify your current benefit elections with The University

How to fill out benefit change request form

1. Gather necessary information: Before filling out the benefit change request form, gather all the relevant information such as your employee ID, current benefits coverage details, and the changes you wish to make.
2. Download or obtain the form: You can typically find the benefit change request form on your company's intranet, HR portal, or from your HR department. If you cannot access it online, reach out to your HR representative for a copy.
3. Fill out personal details: Start by filling out your personal information accurately, including your full name, employee ID, department, contact information, and any other required information.
4. Specify the effective date: Indicate the desired effective date for the changes you are requesting. This could include the start date for new benefits, termination date for existing benefits, or any other relevant dates.
5. Select the benefits to change: Identify the specific benefits you want to change, such as medical insurance, dental coverage, life insurance, retirement plans, etc. Be clear and specific about the changes you want to make, e.g., increasing or decreasing coverage levels.
6. Complete necessary sections: Some benefits change request forms may have additional sections that require additional information. For example, if you want to add a dependent to your healthcare coverage, you may need to provide their name, date of birth, and relationship to you.
7. Review and verify information: Before submitting the form, carefully review all the information you have provided. Make sure there are no errors or missing details that may cause delays in processing your request.
8. Sign and date the form: After reviewing, sign and date the benefit change request form to validate your request. Some forms may require additional signatures, such as an HR representative or supervisor.
9. Attach supporting documentation if necessary: If there are any supporting documents required, such as a marriage certificate for adding a spouse to your benefits, make sure to include them with your completed form.
10. Submit the form: Once you have filled out all the necessary sections, securely submit the completed form to your HR department. Ensure that you keep a copy of the form for your records.

Who needs a benefit change request form?

Employees who wish to make changes to their existing benefits coverage or enroll in new benefits typically need to complete a benefit change request form. This form may vary depending on the company's policies and procedures, but it is generally required for any changes to an employee's benefits package. The form ensures that the HR department has the necessary information to process the requested changes accurately.

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