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BENEFITS ELECTION FORM After completing this form, please send it to your Benefits Coordinator either via fax or email: 8662453659 hhsservicecenter.bef@ngahrhosting.comInformation provided to ERS

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How to fill out benefits election form

01

Review the benefits election form provided by your employer

02

Fill out personal information such as name, address, and employee ID

03

Select the benefits you would like to enroll in or make changes to

04

Indicate the coverage levels you would like for each benefit (i.e. individual, family)

05

Sign and date the form to certify your choices

06

Submit the completed form to the HR department within the deadline

Who needs benefits election form?

01

Employees who are eligible for benefits through their employer

02

Employees who want to enroll in or make changes to their benefits

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What is benefits election form?

The benefits election form is a document that allows individuals to choose their employee benefits, such as health insurance, retirement plans, and other perks offered by their employer.

Who is required to file benefits election form?

All employees who are eligible for benefits provided by their employer are required to file a benefits election form.

How to fill out benefits election form?

To fill out a benefits election form, employees must carefully review the options available to them and select the benefits that best suit their needs. They may need to provide personal information and make selections for each benefit offered.

What is the purpose of benefits election form?

The purpose of a benefits election form is to allow employees to choose the benefits that are most suitable for their needs and circumstances, and to ensure that they are enrolled in the selected benefits.

What information must be reported on benefits election form?

The benefits election form may require employees to report their personal information, such as name, address, social security number, as well as information about their selected benefits, such as health insurance coverage, retirement plans, and other benefits offered by the employer.

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