MICHIGAN CIVIL SERVICE COMMISSION E M P L O Y E E B E N E F I T S D I V I S I O N ON, P. O. Box 30002;CS1820 REV 7/2020Lansing, Michigan 48909 T o l l F r e e : 8 0 0 5 0 5 5 0 1 1 ; F a x : 5 1 7.

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How to fill out the MI CS-1820 online

The MI CS-1820 form is an essential document for individuals seeking to continue their insurance coverage after a qualifying event. This guide provides a comprehensive, step-by-step approach to assist users in completing the form accurately and efficiently.

Follow the steps to complete the MI CS-1820 online:

  1. Press the ‘Get Form’ button to access the MI CS-1820 application and open it in your editor.
  2. Complete Section I, which is designated for the personnel office. Fill in the date the application is sent, the name and phone number of the human resource preparer, the return date, employee identification number, name of the qualified applicant, hire date, address, city, state, zip code, daytime phone number, social security number, department or agency, unit code, and name of the employee or retiree.
  3. Indicate whether the two pay period prepay was used for layoff and provide the qualifying event date, insurance end date, FMLA end date (if applicable), and whether the applicant is eligible for the LTD rider.
  4. In Section II, the applicant must complete this section by checking the boxes for the types of coverage they wish to continue, including options for health, dental, and vision insurances for themselves and any eligible dependents.
  5. Provide the names, dates of birth, and relationships to the employee or retiree for each dependent listed.
  6. Select one of the provided options for life insurance coverage. Ensure only one box is checked.
  7. Sign and date the application at the end of Section II. Make sure to read and understand the terms and conditions regarding enrollment.
  8. Return the completed form via fax, email, or mail to the designated address as noted on the form. Be mindful to submit it by the due date in the upper right corner to avoid losing coverage rights.
  9. After submission, retain a copy of the completed form for your personal records.

Start completing your MI CS-1820 online today to ensure your insurance coverage continues.

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