Enrollment/Change Form definition

Enrollment/Change Form means an agreement substantially in the form attached hereto as Exhibit A (as it may be updated or replaced from time to time) pursuant to which an 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.
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Enrollment/Change Form means the Application/Change Form prescribed by the Administrator and required to be submitted to the Administrator by any person wishing to change his or her benefit or enrollment option or to add or delete coverage of dependents.
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Enrollment/Change Form means that form on which the Participant designates the amount or percentage of the Participant's Compensation to be contributed to the Participant's Salary Deferral Contribution Account, the manner in which such contributions shall be invested, Rollover Contribution information and Beneficiary information.
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Examples of Enrollment/Change Form in a sentence

  • This Enrollment/Change Form is referred to by Internal Revenue Code (IRC) as a Salary Reduction Agreement.

  • Enrollment/Change: Employees may enroll or make a change by completing and submitting a VIP Enrollment/Change Form to the HRS Benefits Office.

  • Employees may enroll or make a change by submitting to the Benefits Office a Voluntary Investment Program Enrollment/Change Form.

  • No statement by the Subscriber in the Enrollment/Change Form shall void his coverage hereunder or be used in any legal proceedings hereunder unless such Enrollment/Change Form or an exact copy thereof is included in or attached to his Member Handbook.

  • Prior to the monies being deducted and placed in Employee's 401k account, Employee shall execute a 401k Enrollment/Change Form reflecting the change in Employee's 401k contribution election.

  • Employees may enroll or make a change by submitting to the Benefits aOfVfiocleuntary Investment Program Enrollment/Change Form.

  • An Employee can change his or her designated percentage contributed to the Plan (including electing that no Payroll Deduction be made) by giving the Company a completed Enrollment/Change Form indicating the change on or before the 15th day of the calendar month preceding the month in which the Employee wants the change to his or her contribution level.

  • To enroll, simply fill out the VantageCare RHS Plan Employee Enrollment/Change Form and return it to your benefits office.

  • Enrollment/Change Form Group Dental Insurance, Vision Care Insurance, Basic Life and Basic AD&D Insurance, Supplemental Life and Supplemental AD&D Insurance, Short Term Disability Insurance, Long Term Disability Insurance provided by: UNITEDHEALTHCARE INSURANCE COMPANY ▇▇▇ ▇▇▇▇▇▇ ▇▇.


More Definitions of Enrollment/Change Form

Enrollment/Change Form means an agreement pursuant to which an 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.
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Enrollment/Change Form means such form as is specified by or otherwise acceptable to the Plan Administrator which sets forth the amount of the Payroll Deductions that the Eligible Employee elects to contribute to the purchase of Shares.
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Related to Enrollment/Change 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.

  • 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.

  • 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.