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Benefit Enrollment and Life Event Change Form - Medical & Dental Benefits - Legislators and Executive Councilors - New Hampshire
Benefit Enrollment and Dental Benefits - Legislators and Executive Councilors is a legal document that was released by the New Hampshire Department of Administrative Services - a government authority operating within New Hampshire.
FAQ
Q: What is the Benefit Enrollment and Life Event Change Form?
A: The Benefit Enrollment and Life Event Change Form is a document used to enroll in or make changes to medical and dental benefits in the state of New Hampshire for Legislators and Executive Councilors.
Q: Who can use the Benefit Enrollment and Life Event Change Form?
A: The form is specifically designed for Legislators and Executive Councilors in New Hampshire.
Q: What can be done with the form?
A: The form can be used to enroll in or make changes to medical and dental benefits.
Q: When should the form be used?
A: The form should be used when enrolling in benefits or making changes during a life event.
Form Details:
- Released on October 21, 2022;
- The latest edition currently provided by the New Hampshire Department of Administrative Services;
- 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 fillable version of the form by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Administrative Services.
Download Benefit Enrollment and Life Event Change Form - Medical & Dental Benefits - Legislators and Executive Councilors - New Hampshire
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