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EFFECTIVE DATE: RECEIVED BY:County of Tenantry DATE:2021 Health Plan Opt-out Form Employees may elect to waive enrollment in the County\'s health insurance coverage in any given Plan Year. Employees

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To fill out the entry date county of, follow these steps:

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Locate the 'Entry Date County of' section in the form.

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Enter the date of entry in the designated field. Please use the format specified.

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Entry date county refers to the date on which an individual or entity entered a particular county.

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Any individual or entity who has entered a county and needs to report the entry date.

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The entry date county form typically requires providing basic information such as name, date of entry, purpose of entry, etc.

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