Form A10385 State Health Benefits Program Enrollment Form for Employees - Virginia

Form A10385 State Health Benefits Program Enrollment Form for Employees - Virginia

What Is Form A10385?

This is a legal form that was released by the Virginia Department of Human Resource Management - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form A10385?
A: Form A10385 is the State Health Benefits Program Enrollment Form for Employees in Virginia.

Q: Who is eligible to use Form A10385?
A: Employees in Virginia who want to enroll in the State Health Benefits Program can use Form A10385.

Q: What is the purpose of Form A10385?
A: The purpose of Form A10385 is to enroll employees in the State Health Benefits Program in Virginia.

Q: What information is required on Form A10385?
A: Form A10385 requires information such as personal details, employment information, dependent information, and health coverage choices.

Q: When should I submit Form A10385?
A: You should submit Form A10385 during your initial enrollment period or during the annual open enrollment period.

Q: Can I make changes to my enrollment using Form A10385?
A: Yes, you can use Form A10385 to make changes to your enrollment during the annual open enrollment period or if you experience a qualifying life event.

Q: Is Form A10385 only for new employees?
A: No, Form A10385 can be used by both new employees and current employees who want to enroll or make changes to their health benefits.

Q: Are there any specific instructions for completing Form A10385?
A: Yes, make sure to carefully read and follow the instructions provided with the form to ensure accurate completion.

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Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Virginia Department of Human Resource Management;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form A10385 by clicking the link below or browse more documents and templates provided by the Virginia Department of Human Resource Management.

Download Form A10385 State Health Benefits Program Enrollment Form for Employees - Virginia

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