
Application to Elect or Waive Pretax USPS Health Benefits Plan Premium I. Purpose Noncareer employees use this form when they become eligible for USPS Health Benefits Plan coverage. During Open Season.
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How to fill out the Form 3119 online
Filling out Form 3119 is an essential step for non-career employees who wish to elect or waive pretax treatment of their USPS Health Benefits Plan premiums. This guide provides a clear and supportive walkthrough for completing the form online, ensuring users can navigate the process with ease.
Follow the steps to successfully complete Form 3119 online:
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by providing your personal information in Section A. Include your name, employee identification number, and contact details as requested. Ensure accuracy to avoid delays.
- In Section B, select to begin pretax treatment. Carefully read the guidelines provided and understand the implications. Initial your acceptance of these terms.
- If you are opting to waive pretax treatment in Section C, ensure that you complete this only if you have previously elected it. Initial your decision to waive.
- In Section D, sign and date the authorization statement. This confirms your understanding of the pretax treatment and authorizes deductions.
- Once all sections are completed, review the form for accuracy. Make necessary updates before finalizing.
- Save your changes, and download or print the completed form for your records.
- Mail the form to HRSSC at the address provided in Section E for processing.
Complete your documents online to manage your health benefits efficiently.
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