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BENTON COUNTY SPOUSE HEALTH PLAN VERIFICATION FORM
A. EMPLOYEE INFORMATION
Name: (Last, First, MI)
Address:
City, State, Zip:B. ENROLLMENT STATUS
Section 1
1My spouse is NOT on the Benton County Health
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Health and welfare benefits are benefits provided by an employer that are designed to promote the overall well-being of employees, such as health insurance, dental insurance, vision insurance, retirement plans, and other similar benefits.
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Employers must report information such as the types of benefits offered, the number of employees receiving each benefit, and the cost of providing each benefit.
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