Examples of Benefit Election Form in a sentence
I certify that I have read, understand, and agree to the terms outlined on this Benefit Election Form.
The Participant has agreed to contribute the sum indicated on the Benefit Election Form to the HSA established hereunder.
Each employee who is eligible for medical and dental insurance coverage may participate in the Pretax Benefit Plan by completing a Benefit Election Form within the Benefit Election Period.
You can apply at any time to increase coverage by filling out a new Benefit Election Form and a Long Term Care/Evidence of Insurability Application.
A Benefit Election Form once filed will remain in effect until the earlier of (a) the Employee’s ineligibility for coverage under the Insurance Plan for whatever reason; and (b) the filing of a new Election Form.