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This document is used by retirees and survivors to enroll or change their dental and vision coverage within the Los Angeles Community College District. It provides instructions for adding or deleting

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How to fill out retiree and survivor enrollment

1. Obtain the retiree and survivor enrollment form from the appropriate agency or organization.
2. Carefully read the instructions provided with the form.
3. Fill out personal information, including full name, address, and date of birth.
4. Provide details about your employment history and retirement benefits.
5. Specify the survivor benefits and the individuals that should be designated as survivors.
6. Attach any required documentation, such as annuity statements or marriage certificates.
7. Review the completed form for accuracy and completeness.
8. Sign and date the form where indicated.
9. Submit the form to the designated agency or organization by the specified deadline.

Who needs retiree and survivor enrollment?

1. Retirees looking to enroll for retirement benefits and ensure survivor benefits for their loved ones.
2. Survivors of deceased retirees who need to enroll to receive benefits.

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What is retiree and survivor enrollment?

Retiree and survivor enrollment refers to the process by which retirees and the surviving family members of deceased employees enroll in benefits programs, such as health insurance, to ensure they receive the appropriate coverage after retirement or after the loss of the employee.

Who is required to file retiree and survivor enrollment?

Retirees who are transitioning from active employment to retirement and the surviving spouses or dependents of employees who have passed away are required to file retiree and survivor enrollment to access the benefits available to them.

How to fill out retiree and survivor enrollment?

To fill out retiree and survivor enrollment, individuals should obtain the appropriate enrollment forms, provide necessary personal and beneficiary information, detail previous employment and benefit history, and submit the completed forms as instructed, often within a specified enrollment period.

What is the purpose of retiree and survivor enrollment?

The purpose of retiree and survivor enrollment is to formally register retirees and survivors for benefit programs, ensuring they receive ongoing health care and retirement benefits, which helps support their financial and health needs after employment or the loss of a loved one.

What information must be reported on retiree and survivor enrollment?

Information that must be reported on retiree and survivor enrollment includes personal identification details (like name and Social Security number), employment history, eligibility for benefits, healthcare coverage preferences, and any dependent information for survivors.