For employees that do not currently have our insurance & wish to enroll, or employees that do not currently have our insuarance and are waiving coverage for 2019.
For employees that currently carry our insurance, & are continuing current coverage, making changes to their existing plan, or are terminating coverage for 2019.
MUST be completed for all employees enrolled in our health plan to receive the reduced premium.
What you need to fill out to waive coverage. This also compares available plans.