Benefit Associates, LLC
1501 South Alexander Street,
Suite 104
Plant City, FL 33565 (813) 719-3937 www.benefitassociatesllc.com
Below find the instructions and forms to enroll in the employee insurance benefits.
Enrollment Process:
Review the plans offered to you and your family by Sample Company. Decide which plans are best for your individual situation, click on the enrollment form below for the plan you wish to enroll in, fill in on the site, if you can, or print the form fill in with a pen, then sign and date. Do this for each benefit you wish to enroll in. The forms should be returned to Human Resources within 7 days of you becoming eligible for benefits.
I you do not wish to enroll in one or any of the plans please print a Decline/Waiver form, indicate the plan you are declining/waiving, sign and date, then return to Human Resources.
This site provides a brief summary of your plans; it is not a contract.
Please see insurance contracts (available from Human Resources) for complete policy details and limitations.
