2013 BECKER COUNTY ENROLLMENT FORM FAMILY VEBA: Fill out & sign online

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Click ‘Get Form’ to open the 2013 BECKER COUNTY ENROLLMENT FORM FAMILY VEBA in the editor.
Begin by filling in your personal information at the top of the form, including your name, birth date, and social security number. Ensure accuracy as this information is crucial for processing.
Next, provide your address details and department along with your date of employment. This section helps establish your eligibility for benefits.
Indicate your marital status and select your preferred dental and vision plans from the options provided. Make sure to check if you or your dependents have coverage elsewhere.
Complete the optional life insurance section by entering current amounts and any desired increases or decreases. This will help tailor your coverage needs.
List all dependents who will be included in any plans, ensuring to provide their names, relationships, birthdays, and whether they are new to any plans.
Finally, review all entries for accuracy before signing and dating the form at the bottom. This confirms your authorization for payroll deductions related to your selected benefits.

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What is a VEBA beneficiary?

The following are examples of non-qualifying benefits for VEBAs: whole life insurance that does not qualify under section 79; accident insurance on property; homeowners insurance; commuting expenses; malpractice insurance; loans (other than in times of distress); savings facilities; pensions; annuities payable at

What benefits cannot be provided in a VEBA?

An employees spouse or eligible dependents may continue to utilize the VEBA account for tax-free reimbursement of qualifying expenses in the same manner as the employee.

Who is eligible for VEBA?

Voluntary employees beneficiary association: 501(c)(9) A voluntary employees beneficiary association under Internal Revenue Code section 501(c)(9) is an organization organized to pay life, sick, accident, or similar benefits to members or their dependents, or designated beneficiaries.

Who is eligible for VEBA dependents?

Covered Individuals Your legal spouse and qualified dependents, including your young-adult children through the calendar year in which they turn age 26, are eligible for coverage.