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2015 Open Enrollment HEALTH REIMBURSEMENT ARRANGEMENT (HRA) Phone (541) 4857488 (800) 4227038 www.manleyplan.com Please return this completed form to your benefits office. Enrollment Change EMPLOYEE
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How to fill out hra enrollment and change
How to fill out HRA enrollment and change:
01
Visit the official website of your employer or the specific department that handles employee benefits.
02
Locate the section or tab that pertains to HRA enrollment and change.
03
Click on the appropriate link or button to access the HRA enrollment and change form.
04
Carefully read the instructions provided on the form to ensure you understand the process and requirements.
05
Fill in your personal details accurately, including your full name, employee identification number, and contact information.
06
Provide the necessary information regarding your desired HRA plan, such as the coverage level and any dependents you wish to include.
07
If you are making changes to an existing HRA plan, clearly indicate the modifications you want to make.
08
Double-check all the information you have entered to ensure it is correct and complete.
09
Submit the filled-out form either electronically through the website or by printing and mailing it to the designated address.
10
Keep a copy of the submitted form for your records.
Who needs HRA enrollment and change:
01
Employees who are newly eligible for an HRA (Health Reimbursement Arrangement) benefit.
02
Existing employees who wish to make changes to their current HRA plan, such as modifying coverage levels or adding/removing dependents.
03
Employees who experience a qualifying life event, such as marriage, divorce, birth, adoption, or a change in employment status, which may require a change to their HRA coverage.
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