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  • State Health Benefits Program Enrollment Form Fillinable

Get State Health Benefits Program Enrollment Form Fillinable

Commonwealth of Virginia State Health Benefits Program Enrollment Form For Retirees, Survivors And LTD Participants InItIal EnROllMEnt DEaDlInES: ? New retirees or long-term disability participants.

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Adults age 19-64 with income up to 138% FPL ($1,677/month for a single person and $2,268/month for a couple). In general, immigrant adults must have Legal Permanent Resident status in the US for at least five years in order to qualify for NJ FamilyCare.

SES without underlying status may choose between the State or the Department Plan. SICK LEAVE. ADMINISTRATIVE LEAVE. ALTERNATIVE WORKWEEK PROGRAM. FAMILY LEAVE. HOLIDAYS -12 paid holidays. STATE HEALTH BENEFITS PROGRAM. DENTAL PROGRAMS. VISION CARE REIMBURSEMENT.

The Retired Group of the State Health Benefits Pro- gram (SHBP) or School Employees' Health Benefits Program (SEHBP) offers medical, prescription, and dental coverage to certain retiring members and their eligible dependents.

The New Jersey State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) offer employees and their covered dependents the opportunity to join a Direct Primary Care doctor's office at no additional cost.

NJ DIRECT HD1500 and NJ DIRECT HD4000 are High Deductible Health Plans (HDHPs) that combine a high deductible health plan with a health savings account (HSA). Eligible preventive services are covered at 100% if in network and do not have a deductible.

How to Enroll For Health Benefits. To enroll, you must obtain and file a Health Benefits Application at your payroll or personnel office or NYCAPS Central. The form must be filed within 30 days of your appointment date (for exceptions, see Effective Dates of Coverage section).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232