Get Employee Enrollment/change Form - Insurance Strategy Inc.

Filling out the Employee Enrollment/Change Form for Insurance Strategy Inc. is essential for managing your insurance enrollment and changes. This guide will provide you with clear instructions to successfully complete the form online, ensuring you can easily navigate through each section.

Follow the steps to complete your application accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the reason for application section. Select the applicable reason including new enrollment, address change, marriage, or divorce. If applicable, fill in the event date and reason.
3. Navigate to the plan information section. Choose the design and coverage plan that best suits your needs, ensuring to select one option per row.
4. Fill out your personal information in the employee information section. Include your last name, first name, middle initial, date of birth, social security number, home address, and employment status.
5. List any dependents you wish to enroll or change in this section. Provide their first and last names, dates of birth, social security numbers, and relationships to you.
6. Complete the coordination of benefits section by indicating whether you or any family member has other vision coverage. Provide details on the individual with other coverage and the insurance carrier information.
7. Sign and date the employee signature section. Acknowledge that you understand the terms regarding the group coverage and your employment status.
8. After completing all sections, ensure you review the information for accuracy. Save your changes, download a copy for your records, and print the form if needed.

Begin filling out your Employee Enrollment/Change Form online today for a seamless insurance experience.