New Employee Benefits Enrollment - Dow Corning
New Employee Benefits Enrollment - Dow Corning
New Employee Benefits Enrollment - Dow Corning
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BENEFIT ENROLLMENT WORKSHEET<br />
After reviewing all the benefit selections use this worksheet to record your FLEX benefit selections to<br />
reference while enrolling via ESS.<br />
Dental<br />
Medical<br />
Vision<br />
BENEFIT PLAN OPTION COVERAGE<br />
LEVEL<br />
Dep Life - child $<br />
Dep Life - SP/DP $<br />
Legal<br />
Long Term Disability<br />
Optional Life<br />
AD&D - employee $<br />
AD&D - Spouse/DP $<br />
HSA $<br />
Dep Daycare FSA $<br />
Healthcare FSA $<br />
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