Before filling out the Cafeteria Plan Enrollment Form below, please make sure you've read the Cafeteria Plan.
Cafeteria Plan Enrollment Information
Important Update for 2025–2026 Plan Year Transitions
If you are making Cafeteria Plan changes that take effect before December 31, 2025, you are required to complete both of the following forms to ensure your elections are processed correctly for each plan year:
Please review and submit both forms as applicable to prevent any delay or disruption in your benefit coverage.
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