Get Kechnie Benefits Employee Enrollment Application 2010-2025

Completing the Kechnie Benefits Employee Enrollment Application online is an important step in securing your benefits. This guide provides a clear, step-by-step approach to help you navigate each section of the form efficiently and accurately.

Follow the steps to complete your application with ease.

1. Press the ‘Get Form’ button to access the document and open it in the editor.
2. Begin by filling out Section A, which includes plan sponsor information. Provide details such as the employer name, firm number, date of full-time employment, group number, regular hours per week, class, and whether you want to waive the waiting period. If you opt for waiving the waiting period, ensure the application is submitted within two weeks of your hire date.
3. In Section B, enter your personal information. This includes your last name, first name, middle name(s), sex, marital status, home phone number, language preference, date of birth, and address. This section is crucial as it identifies you as the plan member.
4. Proceed to Section C to apply for health and dental benefits. Indicate whether you desire single coverage, family coverage, or none at all. If you choose 'none,' be aware that it must be because of coverage through your spouse’s plan.
5. If applicable, complete Section D regarding your spouse’s health and dental coverage. Specify whether they have coverage and provide the necessary details.
6. Move on to Section E to list family information. This section requires you to provide the names, dates of birth, sex, and any relevant status for your spouse and children.
7. In Section F, designate your beneficiaries for life insurance benefits. Input their names, relationship to you, contact information, and the percentage of benefits allocated to them. If there are minors, appoint a trustee.
8. Finally, in Section G, you must sign and date the application, certifying that all information provided is true and complete. Ensure you authorize deductions from your pay for group benefits if applicable.
9. Once you have completed all sections, save your changes and then you can choose to download, print, or share the completed form.

Take the next step in your benefits journey by filling out the Kechnie Benefits Employee Enrollment Application online today.