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ENROLLMENT, CHANGE, CANCELLATION, OR OPT OUT EMPLOYEES ONLY HEALTH AND WELFARE PLANS UPAY 850 (R10/13) University of California Human Resources INSTRUCTIONS Blue Shield Health Savings Plan Use this.

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  1. Select the orange Get Form button to begin modifying.
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  4. Be sure the info you add to the Upay850 is up-to-date and correct.
  5. Include the date to the sample with the Date option.
  6. Click on the Sign button and create a signature. You can find three available alternatives; typing, drawing, or uploading one.
  7. Make sure that every field has been filled in properly.
  8. Click Done in the top right corne to save and send or download the sample. There are several choices for receiving the doc. As an instant download, an attachment in an email or through the mail as a hard copy.

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