Get Flex Enrollment / Change Form - Allegiance - Flex Advantage

This guide provides detailed instructions for completing the Flex Enrollment / Change Form - Allegiance - Flex Advantage online. By following these steps, you can efficiently manage your benefits enrollment or changes in a straightforward manner.

Follow the steps to accurately complete the form online.

1. Press the ‘Get Form’ button to access the Flex Enrollment / Change Form - Allegiance - Flex Advantage and open it in your preferred editor.
2. Fill in the 'Employer' and 'Division' fields with the appropriate information related to your workplace.
3. Enter your Social Security Number (SSN). This is crucial for identifying your account.
4. Select the purpose of your form submission by checking one of the three options: 'Open Enrollment,' 'New Hire,' or 'Change.'
5. Input the Effective Date (mm/dd/yy) and your Birth Date (mm/dd/yyyy) in the designated fields.
6. Provide your full Name, Mailing Address, Phone Number, City, State, and ZIP Code.
7. Indicate your Marital Status by checking either 'Married' or 'Single.'
8. Enter your Email address for communication regarding your benefits.
9. For Flexible Benefits Election Authorization, indicate whether you want to deduct insurance premiums pre-tax by selecting 'Yes' or 'No.' Fill in the fields for Per Pay Period Deduction, Number of Pay Periods, and Total Annual Amount Elected for Medical Spending and Daycare.
10. If applicable, authorize for a debit card by selecting 'Yes' and providing an email address. Optionally, indicate if you would like a card for your spouse and fill in their name, SSN, and birth date.
11. Review the Certification section carefully and confirm that you understand the terms by signing and dating the form.
12. Ensure that a company representative also signs and dates the document for official approval.
13. Finally, save your changes in the editor, and choose to download, print, or share the completed form as needed.

Complete your Flex Enrollment / Change Form - Allegiance - Flex Advantage online today for efficient benefits management.