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Los Angeles Unified School District Benefits Administration 2023 HEALTH BENEFITS ENROLLMENT FORM HALFTIME ACTIVE EMPLOYEES Employee Numberless NameFirst NameAddressCityEmail Address. I. StateClassified
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01
Obtain the unit g health benefits form from your employer or benefits provider.
02
Read through the form carefully to understand the information required.
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Fill out personal details such as name, address, date of birth, and social security number.
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Provide information about your current health insurance plan, if applicable.
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Indicate your choice of health benefits coverage and any additional coverage options.
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Submit the filled out form to the appropriate person or department for processing.

Who needs unit g health benefits?

01
Employees who are eligible for health benefits through their employer.
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Individuals who want to enroll in or make changes to their health benefits coverage.
03
Dependents of eligible employees who may be covered under the unit g health benefits.
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Unit G health benefits refer to the specific health benefits provided to employees under a collective bargaining agreement.
Employers who are parties to the collective bargaining agreement are required to file unit G health benefits.
Unit G health benefits can be filled out by providing the necessary health benefit information for employees covered under the collective bargaining agreement.
The purpose of unit G health benefits is to ensure that employees receive the health benefits they are entitled to under the collective bargaining agreement.
Unit G health benefits must include details of the health benefits provided, the number of employees covered, and any other relevant information.
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