Employee Open Enrollment Announcement Form
Announce and coordinate your company's open enrollment period. Please review all details and acknowledge receipt at the end of this form.
Open Enrollment Title
*
Enrollment Announcement Summary
*
Enrollment Window
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Who is Eligible?
*
Please Select
All Full-Time Employees
All Part-Time Employees
Specific Departments
New Hires Only
Other
Benefits or Plan Options Included
*
Medical
Dental
Vision
Life Insurance
Disability
Flexible Spending Account
Other
Action Required by Employees
*
Key Dates & Deadlines
*
Preferred Communication Method
*
Email
Company Intranet
Printed Materials
Team Meeting
Other
Contact Person for Questions
*
First Name
Last Name
Contact Email Address
*
example@example.com
I acknowledge receipt and understanding of the Employee Open Enrollment Announcement Form.
*
Yes, I acknowledge
Submit
Should be Empty: