Get Employee Acknowledgement Form - Mass.gov - Mass

Filling out the Employee Acknowledgement Form is an essential step in the benefits enrollment process for employees. This guide provides clear and comprehensive instructions on how to complete the form accurately and effectively.

Follow the steps to confidently complete the Employee Acknowledgement Form

1. Click the ‘Get Form’ button to access the document and open it in your chosen editing tool.
2. Begin by reviewing the Benefit Decision Guide thoroughly, as it outlines your available health insurance options. This step is crucial for making informed benefit elections.
3. In the designated area, print your name clearly to ensure proper identification.
4. Affix your signature in the provided space. Your signature confirms that you have reviewed the guide and made your benefit selections based on that information.
5. Enter your Social Security Number in the specified field. This information is important for record-keeping purposes.
6. Date the form in the appropriate section to indicate when you completed it.
7. Review the entire form to ensure all fields are completed accurately. Once confirmed, save your changes. You may wish to download, print, or share the form as needed.
8. Return the signed form to your GIC Coordinator or Benefits Office along with your benefit elections for processing.

Complete your Employee Acknowledgement Form online today to ensure your benefits are processed promptly.