Dental Vision Enrollment/ Change/ Initial Waiver Form

Use this form to enroll in new coverage, add dependents to existing coverage, change your plan selection, or drop coverage.

*If you currently have coverage through Guardian & want to keep everything the same, please see the Benefit Plan Snapshot form.

*If you completed an initial waiver form for Guardian, and want to waive again, you may use the Benefit Plan Snapshot form.

Guardian Enrollment and Change Form.pdf, 10.99 MB; (Last Modified on October 26, 2022)