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Date:SPRINGFIELD LOCAL SCHOOL
2023 2024OPEN ENROLLMENT APPLICATION
(2141 Pickle Road, Akron, Ohio 44312, Attn: Cathy Grubs)
sp_grubbs@springfieldspartans.org
All Information on the registration must
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How to fill out open enrollment form 23
How to fill out open enrollment form 23
01
Gather all necessary information such as personal details, dependent information, and any changes in coverage from previous year.
02
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Double-check all information before submitting the form to ensure accuracy.
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Submit the completed form by the deadline specified by your employer or insurance provider.
Who needs open enrollment form 23?
01
Employees who are eligible for benefits through their employer
02
Individuals who are applying for or renewing health insurance coverage
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What is open enrollment form 23?
Open enrollment form 23 is a document that allows individuals to enroll in or make changes to their health insurance coverage.
Who is required to file open enrollment form 23?
Individuals who wish to enroll in or make changes to their health insurance coverage are required to file open enrollment form 23.
How to fill out open enrollment form 23?
Open enrollment form 23 can be filled out online, by mail, or in person by providing the required information about your health insurance coverage.
What is the purpose of open enrollment form 23?
The purpose of open enrollment form 23 is to allow individuals to enroll in or make changes to their health insurance coverage during specific enrollment periods.
What information must be reported on open enrollment form 23?
Open enrollment form 23 requires information such as personal details, current insurance coverage, and any changes to coverage requested.
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