2020 ENROLLMENT/CHANGE FORM Employee (Participant) …
you must complete the MSC Health BenefitsBuy-Out Waiver Program Enrollment/Change Form and the Health Benefits Application within thirty (30) days after such event to be reinstated, or to receive a pro-rated incentive payment. If you wish to terminate your participation in the Health Benefits Buy-Out Waiver Program and reinstate your City health ................
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