Form A10387 State Health Benefits Program Enrollment Form for Retirees, Survivors and Ltd Participants - Virginia

What Is Form A10387?

This is a legal form that was released by the Virginia Department of Human Resource Management - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: Who is eligible to use Form A10387?
A: Retirees, survivors, and participants in the State Health Benefits Program in Virginia.

Q: What is the purpose of Form A10387?
A: To enroll in the State Health Benefits Program for retirees, survivors, and participants in Virginia.

Q: What information is required on Form A10387?
A: The form requires personal information such as name, address, Social Security number, and health plan selection.

Q: Are there any deadlines for submitting Form A10387?
A: The form must be submitted within 30 days of a qualifying event or during the annual open enrollment period.

Q: Can I make changes to my health plan selection after submitting Form A10387?
A: Changes can be made during the annual open enrollment period or within 30 days of a qualifying event.

Q: Is there a cost associated with participating in the State Health Benefits Program?
A: Yes, participants are responsible for premium contributions and other applicable costs.

Q: Can I cancel my enrollment in the State Health Benefits Program?
A: Yes, participants can cancel their enrollment during the annual open enrollment period or within 30 days of a qualifying event.