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Kentucky Small Group Employee Enrollment Change Form

Kentucky Small Group Employee Enrollment Change Form 2025

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The document is an Employee Enrollment Application for groups with 51 or more employees in Kentucky, requiring employees to provide personal and employment information to enroll in various insurance coverages offered by Anthem Blue Cross and Blue Shield. It includes sections for employee details, reasons for application, types of coverage (medical, dental, vision, life, disability), dependent information, prior coverage details, terms and conditions, and a waiver option for declining coverage.

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See more Kentucky Small Group Employee Enrollment Change Form versions

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Versions	Form popularity	Fillable & printable
2022	4.5 Satisfied (52 Votes)
2017	4.6 Satisfied (48 Votes)
2017	4.8 Satisfied (50 Votes)
2017	4.8 Satisfied (44 Votes)
2016	4 Satisfied (57 Votes)
2015	4 Satisfied (21 Votes)
2012	4 Satisfied (32 Votes)

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What paperwork does a new employee need to fill out?

New employees need to fill out a Form I-9 to verify employment eligibility as well as a W-4 for income tax. In states with an income tax, its necessary to fill out a second W-4.

Does open enrollment apply to new hires?

Annual Open Enrollment: Many employers conduct open enrollment on an annual basis. This allows employees to make changes to their benefit elections for the upcoming calendar year. New Hire Enrollment: Newly hired employees often have a period shortly after their start date to enroll in benefits.

Does Kentucky have open enrollment?

Kentucky provides K12 students and their families some school choice, including charter schools, magnet schools, home schooling and inter- and intra-district public school choice via open enrollment. Kentucky does not a private school choice program.

What forms do new employees need to fill out in Kentucky?

Mandatory New Hire Paperwork in Kentucky Form W-4 (Employees Withholding Certificate) State Tax Withholding Form (K-4) Employer Identification Number (EIN) New Hire Reporting Program. Wage and Hour Regulations.

What is an employee enrollment form?

Enrollment forms record whether employees have enrolled in or waived group benefits. For instance, if you have more than 50 full-time employees, you will need this data to complete IRS forms 1094 and 1095, which record health care coverage.

What forms must an employee complete when beginning a new job?

Both a W-2 and a W-4 tax form. These forms will come in handy for both you and your new hire when its time to file income taxes with the IRS. A DE 4 California Payroll tax form. Issued by the Employment Development Department, this form helps employees calculate the correct state tax withholding from their paycheck.

Kentucky Small Group Employee Enrollment Change Form 2025

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