Health Plan & Life Insurance 2026

1. Click ‘Get Form’ to open the Health Plan & Life Insurance application in the editor.
2. Begin by selecting the reason for your application from the options provided, such as 'New hire' or 'Open enrollment'. Ensure you fill in any relevant dates.
3. In Section 1, review the important enrollment guidelines for Specialty Benefits coverage. Make sure to understand the requirements for dental, vision, and life insurance enrollments.
4. Proceed to Section 2 where you will select your desired medical benefits plan. Fill in the plan names as applicable and check any additional options like HRA or FSA.
5. Complete Section 3 with your personal information including Social Security number, employment status, and contact details. Be thorough to avoid delays.
6. If enrolling dependents, move to Section 4 and provide their information accurately. Indicate which plans they are enrolling in.
7. In Section 5, designate your life insurance beneficiaries by providing their names and relationships. Ensure this section is completed correctly.
8. Finally, review all sections for accuracy before signing in Section 7 to authorize your application.

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