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Department of Employee Insurance Keep.KY.personnel.KY.gov 8885818834DO NOT STAPLE 2025 EMPLOYEE BENEFITS ENROLLMENT/CHANGE FORM Section 1: To be completed by the IC/HOG IN OFFICE USE ONLY CHRIS Personnel
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Retiree health insurance enrollment changes refer to the updates or modifications made by retirees to their health insurance plans during specified enrollment periods.
Retirees who wish to modify their health insurance coverage, enroll in a new plan, or discontinue their existing coverage are required to file retiree health insurance enrollment changes.
To fill out retiree health insurance enrollment changes, individuals should gather necessary personal information, select the desired health plan options, and complete the required forms provided by their health insurance provider or employer.
The purpose of retiree health insurance enrollment changes is to allow retirees to adjust their health insurance coverage according to their changing needs, which may include adding dependents, switching plans, or changing providers.
Information that must be reported includes the retiree's personal identification details, current health plan information, requested changes in coverage, and any dependent information.
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