ENROLLMENT FORMS
Health benefits changes( adding
or deleting dependents).
 Complete
worksheet from #1 through #9 then #11
Choose
your corresponding dental coverage form, complete, sign and
date.
Complete,
sign and date vision form
Use the
life insurance form to amend/change your elections.
Send all documents via campus mail to
employee benefits.
Do not email.
An original of the worksheet will be sent out for signature and date.
If you plan to travel abroad to
adopt a child, be advised that we cannot process an enrollment
form prior to your departure. A copy of the adoption document
is required. This document must specify the child ‘s
name, date of birth and final adoption date. Please make
sure dates are in numerals.
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