2019-20 TLC Personal Data Change Form - The Local Choice-2026

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  1. Click ‘Get Form’ to open the 2019-20 TLC Personal Data Change Form in the editor.
  2. Begin by filling out the Participant (Subscriber) Information section. Enter your Subscriber ID or Social Security Number, followed by your name as shown on your identification card.
  3. Indicate the effective date of these changes by selecting the month, day, and year.
  4. If you are changing your name, address, phone number(s), or email(s), check the appropriate box and provide the new information in the designated fields.
  5. For changes regarding your Date of Birth or Gender, fill in the required fields accordingly.
  6. If applicable, update any covered dependent’s personal data by entering their details in the provided sections.
  7. Finally, sign and date the form before submitting it to your employer’s benefits administrator through email, fax, or mail as specified.

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