Get 2009 Flexible Benefits Allowance Subsidy Application

Filling out the 2009 Flexible Benefits Allowance Subsidy Application online is a straightforward process. This guide will walk you through each step to ensure that you provide accurate information and complete your application correctly.

Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to acquire the form and open it in your desired format.
2. Begin by entering your first and last name in the designated field at the top of the form.
3. Provide your department name to identify your affiliation and ensure proper processing.
4. Indicate which members of your household you are enrolling in a University-sponsored medical plan by selecting one of the following options: spouse only, spouse and child, spouse and children, child only, or children.
5. Read and check the box confirming that you have reviewed your total household income as reported on your 2007 federal income tax return. Ensure you understand the definition of 'household.'
6. Select the appropriate income bracket from the provided matrix that represents your total household income reported in 2007. Review the options carefully to choose the one that applies to your situation.
7. Provide your signature to certify that the information is accurate and that you understand the implications of providing false information. This step is crucial for maintaining compliance.
8. Enter the date of completion to finalize your application process.
9. After filling out all fields, save any changes you made. You can then download, print, or share the form as needed.

Complete the 2009 Flexible Benefits Allowance Subsidy Application online now for a smooth benefits enrollment experience.