Health Insurance

For ALL qualifying employees. Use this form to enroll, make changes, or waive health insurance coverage for 2026.

• Anthem Vision and Dental Application 

Please complete and return the enrollment form only if:
A. You currently have coverage but wish to drop or change plans, or
B. You would like to enroll in coverage.

If you are making no changes, there is no need to submit anything — your existing coverage will automatically roll over.