Get Ca Sfhss Open Enrollment Application - San Francisco 2020-2025
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How to fill out the CA SFHSS Open Enrollment Application - San Francisco online
This guide provides clear, step-by-step instructions to assist users in completing the CA SFHSS Open Enrollment Application online. Whether you are making changes to your medical or dental coverage or enrolling in a Flexible Spending Account, our comprehensive guide will support you throughout the process.
Follow the steps to complete your application effectively.
- Press the ‘Get Form’ button to obtain the application form and open it in your preferred browser or editor.
- Enter your personal information in the designated fields. This includes your last name, first name, street address (no P.O. Boxes), middle initial, city, state, zip code, social security number, gender, birth date, email address, and phone numbers.
- Select your medical plan from the options provided. Review the choices carefully to ensure you choose the plan that best fits your needs.
- Choose your dental plan. If you do not wish to have dental coverage, select the ‘No Dental Coverage’ option.
- If you wish to enroll in vision plans, indicate your preference between the VSP Basic and VSP Premier plans. Remember that VSP Premier incurs an additional cost.
- If you are adding or dropping any dependents from your coverage, complete the dependent section by filling in the required information for each individual, including their last name, first name, birth date, gender, and social security number.
- Indicate whether you want to enroll in a Flexible Spending Account. Provide the total annual amount you would like to contribute, keeping in mind the minimum and maximum limits.
- Review all information entered for accuracy. Ensure that all necessary eligibility documentation is prepared for submission.
- Sign the application to certify that all provided information is true and correct. Include the date of your signature.
- Finally, submit the completed form along with the required documentation by mailing or dropping it off at SFHSS, or fax it if necessary. Remember to keep a copy of the form for your records.
Complete your CA SFHSS Open Enrollment Application online today and ensure your health coverage is updated.
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To enroll in the San Francisco health plan, start by reviewing your options through the SFHSS portal. You will typically need to complete the CA SFHSS Open Enrollment Application - San Francisco during the designated enrollment period. Carefully follow the instructions provided and ensure all necessary documentation is submitted on time to benefit from the available health plans.
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