• Employee Benefits Open Enrollment Letter
• Employee Benefits Open Enrollment Memo
• Employee Benefits Open Enrollment Flier
• Voluntary Wellness Program Explanation & Form
• Colonial Life Flier

Enrollment/Waiver Form Instructions

Please note that we have attached the enrollment and waiver forms to our website. You will need to print the related form only, if you wish to make changes. Only complete the highlighted areas of the related form. Place a “X” in all selection boxes needed. Please don’t forget to write the plan you have selected on the first line of Section 3. If you are adding dependents to your coverage additional documentation will be needed.

If you have any questions or concerns, contact me by phone at (276) 385-1207 or email at brittany.gillespie@tazewellcounty.org.

• Waiver Form
• Enrollment Add/Change Form