Benefits Enrollment/Change Form - Full-time (Health, Dental and Insurance)
published: 17-Apr-2008 PDF (112kb) Benefits_Enrollment_Form_-_Full-time_with_life_insurance._Revised_September_2013.pdf
Full-time staff and faculty should use this form to enrol or make changes to health, dental and life insurance benefits (e.g. beneficiary changes, name change, etc.).
NOTE: This information may also need to be updated in other areas such as Pension. Please refer to the Life Changes/Events page for additional information.
updated June 03/15