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This form is used by employees of New Mexico Public Schools Insurance Authority (NMPSIA) to report changes in their benefits enrollment status, including medical, dental, vision, and life insurance coverage. It allows employees to add or drop coverage, update personal information, and ensure compliance with eligibility requirements. The form must be submitted to the Employee Benefits Office within a specified period following a qualifying event.
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How to fill out employee change card

01
Gather necessary employee information including name, ID, and department.
02
Review the form to identify sections that require updates.
03
Fill in the updated details in the appropriate sections of the card.
04
Double-check for accuracy and completeness of information.
05
Obtain required signatures from the employee and relevant supervisors.
06
Submit the completed employee change card to the HR department for processing.

Who needs employee change card?

01
Employees who are changing their job title or responsibilities.
02
Employees who are transferring to a different department.
03
Employees who are updating their personal contact information.
04
Employees who have changes in their compensation or benefits.
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An employee change card is a document used by employers to report changes in the employment status, such as hiring, termination, or changes in personal details of an employee.
Employers are required to file an employee change card for each employee in their organization whenever there is a significant change in their employment status.
To fill out the employee change card, the employer should provide the employee's personal information, the nature of the change (e.g., hire, termination, or change of status), and any relevant dates and signatures as required.
The purpose of the employee change card is to keep accurate records of employees' employment status changes, ensuring compliance with labor laws and facilitating accurate payroll processing.
Information that must be reported typically includes the employee's full name, employee ID, nature of the change (e.g., hire, termination, promotion), effective date of the change, and any other pertinent details.
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