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Franklin Local School District Board of Education Policy Manual6.091 Page 3COMPLETE ONE FORM PER FAMILY Franklin Local School DistrictOpen Enrollment Interdistrict Application for School Year 20___

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Who needs inter- open enrollment form?

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Individuals who are looking to enroll in inter- open programs or courses offered by the institution.

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What is inter- open enrollment form?

An inter- open enrollment form is a document used to request a change in healthcare coverage outside of the regular enrollment period.

Who is required to file inter- open enrollment form?

Individuals who experience a qualifying life event such as getting married, having a baby, or losing other coverage are required to file an inter- open enrollment form.

How to fill out inter- open enrollment form?

To fill out an inter- open enrollment form, individuals need to provide their personal information, details of the qualifying life event, and select a new healthcare plan.

What is the purpose of inter- open enrollment form?

The purpose of an inter- open enrollment form is to allow individuals to make changes to their healthcare coverage outside of the regular enrollment period due to qualifying life events.

What information must be reported on inter- open enrollment form?

Information such as personal details, qualifying life event details, and selection of a new healthcare plan must be reported on an inter- open enrollment form.

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