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ANNIVERSARY CHANGE DUE TO LEAVE OF ABSENCE This Anniversary Change Form must be completed by the Department after an employee returns from a leave of absence exceeding fifteen (15) calendar days.
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How to fill out anniversary change due to:

01
Start by obtaining the necessary forms or documents required to make an anniversary change due to. These forms may be available online or through your employer or insurance provider.
02
Ensure you have all the relevant information and documentation needed to complete the forms accurately. This may include personal details, such as your name, address, and contact information, as well as specific information related to the change being requested, such as the reason for the change and any supporting documentation.
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Carefully read through the instructions provided with the forms to understand the requirements and any additional documentation that may be needed.
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Complete the forms accurately and legibly. Double-check all the information you provide to avoid any mistakes or errors.
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If required, attach any supporting documentation as instructed. This may include proof of a qualifying event or any other relevant documents to support your request.
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Review the completed forms and all attached documentation to ensure everything is in order. Make any necessary corrections or additions before submitting.
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Submit the completed forms and any required documentation according to the instructions provided. This may involve mailing the forms or submitting them electronically through an online portal.
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Keep a copy of the completed forms and any related documentation for your records.

Who needs anniversary change due to:

01
Individuals who have experienced a qualifying life event, such as marriage, divorce, birth, adoption, or loss of coverage, may need to make an anniversary change due to.
02
Employees who are enrolled in a benefit program offered by their employer may need to make changes to their coverage due to changes in their employment status or personal circumstances.
03
Individuals who are enrolled in an insurance plan, such as health insurance or life insurance, and need to make changes to their coverage may also need to fill out an anniversary change due to form. This could include changes to beneficiaries, coverage levels, or other aspects of the policy.
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Anniversary change is due to any updates or changes that need to be made annually.
Any individual or organization that has previously made changes or updates that need to be reported annually.
Anniversary change can be filled out online or submitted through mail by providing the required information.
The purpose of anniversary change is to ensure that all necessary updates and changes are reported in a timely manner.
Information such as updated contact details, changes in ownership, or any other relevant updates.
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