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CUE STA COLLEGE INSURANCE/BENEFITS 20232024 OPEN ENROLLMENT PLAN SELECTION FORM Please designate your selection by checking the box next to your choice and initialing on the line next to the box.
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How to fill out vision plan selection form
How to fill out vision plan selection form
01
Step 1: Obtain a vision plan selection form from your employer or insurance provider.
02
Step 2: Fill in your personal information such as name, address, and date of birth.
03
Step 3: Choose the vision plan that best fits your needs and budget.
04
Step 4: Sign and date the form to confirm your selection.
05
Step 5: Submit the completed form to your employer or insurance provider.
Who needs vision plan selection form?
01
Employees who are eligible for vision insurance through their employer.
02
Individuals who are purchasing vision insurance on their own.
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What is vision plan selection form?
Vision plan selection form is a form that allows individuals to choose their preferred vision insurance plan.
Who is required to file vision plan selection form?
Employees who are eligible for vision insurance benefits through their employer are required to file the vision plan selection form.
How to fill out vision plan selection form?
To fill out the vision plan selection form, individuals need to provide their personal information, select a vision insurance plan, and sign the form.
What is the purpose of vision plan selection form?
The purpose of the vision plan selection form is to allow individuals to indicate their choice of vision insurance coverage.
What information must be reported on vision plan selection form?
The vision plan selection form requires individuals to report their name, contact information, insurance plan selection, and signature.
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