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APPLICATION FOR GROUP BENEFITS Solstice Health Insurance Company (Solstice), Post Office Box 19199, Plantation, Florida 33318 | Ph. 877.760.2247 | Fax 954.370.1701SECTION I GROUP INFORMATION Legal

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How to fill out solstice enrollmentchange form

01

Obtain the solstice enrollment change form from the HR department or download it from the company's website.

02

Fill out your personal information including name, address, and employee ID.

03

Indicate the changes you would like to make to your enrollment such as adding or removing dependents, changing coverage levels, or opting in/out of certain benefits.

04

Provide any supporting documentation required for the changes you are requesting.

05

Double-check all the information you have provided for accuracy before submitting the form.

06

Sign and date the form to attest to the accuracy of the information and submit it to the HR department for processing.

Who needs solstice enrollmentchange form?

01

Employees who want to make changes to their benefits enrollment such as adding or removing dependents, changing coverage levels, or opting in/out of certain benefits.

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What is solstice enrollmentchange form?

Solstice enrollmentchange form is a document used to make changes to enrollment in a solstice program.

Who is required to file solstice enrollmentchange form?

Any individual or organization enrolled in a solstice program who needs to make changes to their enrollment.

How to fill out solstice enrollmentchange form?

You can fill out the solstice enrollmentchange form by providing your current enrollment information and indicating the changes you wish to make.

What is the purpose of solstice enrollmentchange form?

The purpose of the solstice enrollmentchange form is to allow individuals or organizations to update their enrollment information in a solstice program.

What information must be reported on solstice enrollmentchange form?

The solstice enrollmentchange form typically requires information on the individual or organization's current enrollment status and the changes they wish to make.

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