PDF
Word
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.
Retirement Health Benefits and Basic Life Insurance Enrollment Form - West Virginia
Retirement Health Benefits and Basic Life Insurance Enrollment Form is a legal document that was released by the West Virginia Public EmployeesInsurance Agency - a government authority operating within West Virginia.
FAQ
Q: What is the Retirement Health Benefits and Basic Life Insurance Enrollment Form?
A: The Retirement Health Benefits and Basic Life Insurance Enrollment Form is a document used by employees in West Virginia to enroll in retirement health benefits and basic life insurance.
Q: Who is eligible to enroll in retirement health benefits and basic life insurance in West Virginia?
A: Employees in West Virginia who meet the eligibility criteria set by their employer are eligible to enroll in retirement health benefits and basic life insurance.
Q: What are retirement health benefits?
A: Retirement health benefits are medical, dental, and vision benefits provided to employees after they retire.
Q: What is basic life insurance?
A: Basic life insurance is a type of life insurance coverage provided to employees to protect their families financially in the event of their death.
Q: How can I enroll in retirement health benefits and basic life insurance?
A: You can enroll in retirement health benefits and basic life insurance by completing the Retirement Health Benefits and Basic Life Insurance Enrollment Form and submitting it to your employer.
Q: What information do I need to provide on the enrollment form?
A: You will need to provide personal information such as your name, address, social security number, and beneficiary information on the enrollment form.
Q: When should I submit the enrollment form?
A: You should submit the enrollment form within the enrollment period specified by your employer.
Q: Can I make changes to my enrollment after the initial enrollment period?
A: It depends on the specific rules and policies set by your employer, but generally, there may be limited opportunities to make changes to your enrollment after the initial enrollment period.
Q: What happens if I don't enroll in retirement health benefits and basic life insurance?
A: If you don't enroll in retirement health benefits and basic life insurance, you may not have access to these benefits and protections.
Form Details:
- Released on January 1, 2021;
- The latest edition currently provided by the West Virginia Public Employees Insurance Agency;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the West Virginia Public Employees Insurance Agency.
Download Retirement Health Benefits and Basic Life Insurance Enrollment Form - West Virginia
1
2
3
4
