This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Retiree Health Benefits Enrollment and Change Form is a legal document that was released by the Maryland Department of Budget and Management - a government authority operating within Maryland.
Q: What is the Retiree Health Benefits Enrollment and Change Form?
A: The Retiree Health Benefits Enrollment and Change Form is a document used in Maryland for retirees to enroll in or make changes to their healthcare benefits.
Q: Who can use the Retiree Health Benefits Enrollment and Change Form?
A: The Retiree Health Benefits Enrollment and Change Form can be used by retirees in Maryland.
Q: What can I use the form for?
A: You can use the form to enroll in or make changes to your healthcare benefits as a retiree.
Q: Do I need to submit the form every year?
A: Yes, you need to submit the form every year during the designated enrollment period to enroll in or make changes to your healthcare benefits.
Q: What information do I need to provide on the form?
A: You will need to provide your personal information, such as name and address, as well as information about your healthcare plan choices.
Q: Can I make changes to my healthcare benefits outside of the designated enrollment period?
A: Generally, you can only make changes to your healthcare benefits during the designated enrollment period, unless you experience a qualifying life event.
Q: What happens if I don't submit the form?
A: If you don't submit the form during the designated enrollment period, you may not be able to enroll in or make changes to your healthcare benefits until the next enrollment period.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Maryland Department of Budget and Management.