Contact your employer if you don’t have these.
If for any reason you are not able to store or print your completed enrollment form, contact Eligibility Services at (800) 279-4000. You will be mailed a paper copy free of charge.
* To maintain the security and confidentiality of the information you send over the Internet, we use high-level encryption technology called “128-bit encryption.” Your Web browser is likely to support that level of encryption unless you have outdated software. For example, Internet Explorer 5.5 and above, Mozilla FireFox 1.0 and above and Netscape 4.75 and above, all support high-level encryption. If your browser does not support 128-bit encryption please visit the Web site that provides upgrades to your browser software.