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Enrollment Change Form - MSU Human Resources

Enrollment Change Form - MSU Human Resources 2025

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The document is an Open Enrollment Offline Enrollment/Change Form for Michigan State University (MSU) employees to enroll, change, or delete benefits for themselves and their eligible dependents. It outlines the process for adding or removing dependents from health and dental plans, including required documentation for changes due to marriage, birth, or adoption. The form also includes sections for Flexible Spending Accounts (FSA), Health Savings Accounts (HSA), and life insurance options, along with an authorization section for payroll deductions and medical record access.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the purpose of an enrollment form?

Student enrollment is the process new students go through when joining a new school, which typically only happens once. During this process, students, parents, or guardians complete student enrollment forms to admit them to the school.

What is the purpose of a health enrollment form?

This enrollment form allows individuals to apply for group health and dental coverage. Its designed for employees to provide necessary personal information, dependent details, and coverage choices.

What is an enrollment deposit form?

A college enrollment deposit secures your spot at the school youve made a commitment to. Theyre often due by May 1, though the exact deadline can vary depending on the college. Its likely one of the first payments youll be making to the college of many!

What does change in enrollment mean?

A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if youve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

What is the late enrollment fee for Michigan State University?

All students who initially enroll on the first day of classes or after will be charged a $100 late enrollment fee.

How do I contact MSU HR?

By phone: 517-353-4434 or 800-353-4434.

What is an enrollment change form?

Enrollment/Change Form means an agreement pursuant to which an Employee may elect to enroll in the Plan, to authorize a new level of payroll deductions, or to stop payroll deductions and withdraw from an Offering Period.

How do I contact MSU enrollment?

Arrange visitor enrollment in 150 Administration Building, or call 517-355-3300.

Enrollment Change Form - MSU Human Resources 2025

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