Benefits Enrollment Form definition

Benefits Enrollment Form means the form or forms, including a Salary Reduction Agreement, evidencing an Eligible Employee’s selections from among the various Benefits and the amount to be contributed towards various Benefits for a Plan Year or portion of a Plan Year.
Sample 1Sample 2
Benefits Enrollment Form means the form or forms, including a Salary Reduction Agreement, evidencing an Eligible Employee's selections from among the various Benefits and the amount to be contributed towards various Benefits for a Plan Year.
Sample 1
Benefits Enrollment Form means a form provided by the Employer on which an Eligible Employee will list all of their dependents.
Sample 1

Examples of Benefits Enrollment Form in a sentence

  • The normal effective date of enrollment will be the first of the month following the date the employee's Health Benefits Enrollment Form is received, subject to the terms and conditions of the CalPERS Health Plan.

  • The Part-time unit member must enroll annually (See Appendix: Medical Benefits, Enrollment Form for Part-time Faculty).

  • The Benefits Enrollment Form needs to be filed before any applicable benefit or plan entry dates with certain exceptions applying with respect to special enrollment rights under HIPAA.

  • In the case of newly eligible employees, the Benefits Enrollment Form needs to be submitted to the Plan Administrator in advance of participation in accord with the requirements of each specific plan or program.

  • The normal effective date of enrollment will be the first of the month following the date the employee's Health Benefits Enrollment Form is received, subject to the terms and conditions of the CALPERS Health Plan.

  • An individual is required to file a Benefits Enrollment Form before either one of two dates.


More Definitions of Benefits Enrollment Form

Benefits Enrollment Form means the form or forms, evidencing an Eligible Employee's selections from among the various Benefits and the amount to be contributed towards various Benefits for a Plan Year or portion of a Plan Year.
Sample 1
Benefits Enrollment Form means a form provided by the Employer on which an Eligible Employee will list all of their dependents insured under the employer’s group health plan.
Sample 1

Related to Benefits Enrollment Form

  • Enrollment Form means an agreement pursuant to which an Eligible Employee may elect to enroll in the Plan, to authorize a new level of payroll deductions, or to stop payroll deductions and withdraw from an Offering Period.

  • Deferral Election Form means the form established from time to time by the Plan Administrator that the Director completes, signs and returns to the Plan Administrator to designate the amount of the Deferrals.

  • Election Form means the form established from time to time by the Committee that a Participant completes, signs and returns to the Committee to make an election under the Plan.

  • Enrollment Agreement means an agreement between the Company and an employee, in such form as may be established by the Company from time to time, pursuant to which the employee elects to participate in this Plan, or elects changes with respect to such participation as permitted under the Plan.

  • Enrollment means the number of students who are enrolled in a school operated by the district on October 1. A student shall be counted as one whether the student is enrolled as a full-time or part-time student. Students enrolled in prekindergarten programs shall not be counted.

  • Distribution Election Form means the form established from time to time by the Plan Administrator that the Director completes, signs and returns to the Plan Administrator to designate the time and form of distribution.

  • Open enrollment means a period of time as defined in rule

  • Deferral Agreement means an irrevocable agreement entered into between a Nonemployee Director and the Company to authorize the Company to reduce the amount of the Nonemployee Director’s Annual Retainer and credit the amount of such reduction to the Plan consistent with the requirements of Section 409A of the Code. A Deferral Agreement shall contain such provisions, consistent with the provisions of the Plan, as may be established from time to time by the Company or the Board, including without limitation:

  • Beneficiary Designation Form means the form established from time to time by the Plan Administrator that the Executive completes, signs, and returns to the Plan Administrator to designate one or more Beneficiaries.

  • Declining enrollment means a decrease in the District's total enrollment or enrollment in a particular program or curricular / instructional offering which in the sole judgment of the board of education may adversely affect the District's current or future funding and/or the necessity of maintaining certain current or future class sections or curricular / instructional offerings.

  • Deferral Election means the Participant’s election under Section 3.1 to defer all or a portion of his or her Compensation.

  • Enrollment Date means the first day of each Offering Period.

  • Salary reduction plan means a benefit plan whereby state and

  • Disenrollment means either voluntary or involuntary termination of a participant from the Independent Choices Program.

  • Beneficiary designation means the naming in a governing instrument of a beneficiary of an insurance or annuity policy, of an account with POD designation, of a security registered in beneficiary form (TOD), of a pension, profit-sharing, retirement, or similar benefit plan, or of another nonprobate transfer at death.

  • Annual Enrollment Period or "Enrollment Period" means the period before each policy anniversary so designated by the Sponsor and Lincoln during which you may enroll for coverage under this policy.

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • Open Enrollment Period means an enrollment period during which time any Eligible Employee and/or Dependent may apply to become a Subscriber and/or Covered Dependent, and existing Subscribers may apply to change to another provider network or coverage option, if available, or elect to terminate coverage.

  • Distribution Election With respect to any Series, as specified in the related Supplement.

  • Initial Enrollment Period means one of the following periods during which you may first enroll for coverage under this plan:

  • Provider Enrollment means an agreement between the Department and a Medicaid provider to provide room and board and deliver care and services to a Medicaid eligible individual in an adult foster home for compensation.

  • Special Enrollment Period means a period of time allowed under this Plan, other than the eligible person’s Initial Enrollment Period or an Open Enrollment Period, during which an eligible person can request coverage under this Plan as a result of certain events that create special enrollment rights.

  • Payment Election means an election pursuant to Section 5.1.

  • Salary Reduction Agreement means an agreement between a dis- trict and an employee to reduce the employee’s salary for the pur- pose of making direct contributions to or purchases of a qualified investment product. Art. 6228a-5, Sec. 4(5), Tex. Rev. Civ. Stat.

  • Letter of Transmittal and Election Form means the letter of transmittal and election form(s) to be delivered by Company to the Company Shareholders and Company RSU Holders and providing for the Company Shareholder’s and Company RSU Holders election with respect to the Consideration;

  • Adoption Agreement means the written agreement pursuant to which the Employer adopts the Plan. The Adoption Agreement is a part of the Plan as applied to the Employer.