For your legal protection be sure to have the employee complete, sign and date an enrollment application for each coverage they choose. Please be sure to keep a copy of the enrollment form in your employee documentation files.
Please be sure to include the following information on every enrollment: date of hire, date of birth, effective date of coverage, zip code, social security number, for all enrollees and covered dependents. |
| Submit the completed enrollment form by: |
| E-mail: | When submitting enrollments by e-mail be sure to scan and attach the enrollment forms and send to mrw@benefitassociatesllc.com |
| Fax: | Please fax to (813) 759-1789 [Get a Fax Sheet- Opens a new window] |
| Regular Mail: | When mailing please only send us a copy of the enrollment forms, the employer should retain the original signed copy of all applications. If an enrollment needs to be done immediately please send by e-mail or fax.
Mail to: ATTN: ENROLLMENT
BENEFIT ASSOCIATES
1501 S. Alexander St. #104
Plant City, Fl 33566
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