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OPTIONAL BENEFITS CHANGE FORM 644 MAIN ST PO BOX 220 MONCTON NB E1C 8L3 Toll-free Line: 18889197378 MembersOptionalBenefits@medavie.bluecross.caInstructions: If applying for an increase in coverage

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How to fill out optional benefits change form

01

Obtain a copy of the optional benefits change form from your HR department.

02

Fill in your personal information such as name, employee ID, and contact information.

03

Review the current benefits you are enrolled in and decide which ones you would like to change or add.

04

Complete the sections related to the changes you want to make, including selecting new benefits options and providing any required information or documentation.

05

Double-check your form for accuracy and completeness before submitting it to HR.

Who needs optional benefits change form?

01

Employees who want to make changes to their optional benefits such as health insurance, dental coverage, retirement contributions, etc., need to fill out the optional benefits change form.

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What is optional benefits change form?

Optional benefits change form is a document used to request changes to optional benefits like healthcare coverage, retirement plans, and other perks.

Who is required to file optional benefits change form?

Employees who wish to make changes to their optional benefits are required to file the optional benefits change form.

How to fill out optional benefits change form?

To fill out the form, employees must provide personal information, select the benefits they wish to change, and submit the form to their HR department.

What is the purpose of optional benefits change form?

The purpose of the optional benefits change form is to allow employees to make changes to their optional benefits outside of the regular enrollment period.

What information must be reported on optional benefits change form?

Employees must report their personal information, the benefits they wish to change, and any supporting documentation required.

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