Termination of Voluntary Insurance Plans
I acknowledge that I cannot enroll or re-enroll into any voluntary insurance plan, except during the District's open enrollment for voluntary plans or as a newly hired or rehired employee. This includes the plan(s) that I am currently terminating. There are no qualifying events in which to re-enroll outside of the District's open enrollment period or as a newly hired or rehired employee. I understand that if I terminate a voluntary life policy that I will not have the benefit of a guaranteed issued policy or the same limits and may be subject to a Statement of Health form.
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Please terminate the following voluntary insurance plan(s):
**Please note** MetLife Legal Plan, American Fidelity Accident (pre-tax), Cancer (pre-tax) are only able to be cancelled during the Open Enrollment period.                                                                                                                                                                                                          Thank you,
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