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Form 1162 Revised 1/17/2018STATE OPTIONAL RETIREMENT PROGRAM (STATE ORP) NOTICE OF TERMINATION OR Changeling or type in black inks Public Employee Benefit Authority Attention: Enrollment 202 Arbor

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How to fill out hrokstateedusite-filesbenefitsplan selection form retiree

01

To fill out the hrokstateedusite-filesbenefitsplan selection form retiree, follow these steps:

02

Obtain the form from the HR department or download it from the official website.

03

Fill in personal information such as name, address, and contact details.

04

Provide retirement details such as date of retirement and retirement plan information.

05

Select the desired benefits plan options by carefully reading and understanding the provided choices.

06

If any additional documents are required, ensure to attach them with the form.

07

Review the filled form for accuracy and completeness.

08

Sign and date the form.

09

Submit the filled form to the HR department either in person or through the designated method mentioned in the form instructions.

10

Keep a copy of the filled form for future reference.

Who needs hrokstateedusite-filesbenefitsplan selection form retiree?

01

Anyone who is retiring from the organization and wants to select their benefits plan is required to fill out the hrokstateedusite-filesbenefitsplan selection form retiree. It is specifically designed for retirees to indicate their choices regarding the benefits they wish to receive during their retirement period.

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What is hrokstateedusite-filesbenefitsplan selection form retiree?

The hrokstateedusite-filesbenefitsplan selection form retiree is a document used to choose healthcare benefits for retired individuals.

Who is required to file hrokstateedusite-filesbenefitsplan selection form retiree?

Retirees who are eligible for healthcare benefits through the state program are required to file the hrokstateedusite-filesbenefitsplan selection form.

How to fill out hrokstateedusite-filesbenefitsplan selection form retiree?

The hrokstateedusite-filesbenefitsplan selection form retiree can be filled out online or submitted in person at the designated office. It requires personal information, healthcare plan selections, and beneficiary details.

What is the purpose of hrokstateedusite-filesbenefitsplan selection form retiree?

The purpose of the hrokstateedusite-filesbenefitsplan selection form retiree is to allow retired individuals to choose their healthcare benefits according to their needs and preferences.

What information must be reported on hrokstateedusite-filesbenefitsplan selection form retiree?

The hrokstateedusite-filesbenefitsplan selection form retiree requires reporting of personal details, healthcare plan selections, dependent information, and beneficiary designations.

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