USFWC Open Enrollemnt Election

Please enter your information to enroll/disenroll into the USFWC benefit plans. If you want the benefit, make sure to select the plan you want. If you do not want the benefit, select "Waive". IF you are CURRENTLY enrolled and "Waive" is showing, you will be REMOVED from the insurance.

Due to the requirements of the companies that run these insurance plans, we must collect legal names and legal genders. The USFWC strives to be a trans-affirming organization, so if it is accurate to refer to you as a name or gender different from your legal name/gender, in that case that it is necessary to communicate with you or your co-op regarding your plan, please indicate that in the 'notes' field.

This is an OPEN ENROLLMENT form so the effective date of the insurance / benefits will be 1/1/2022.

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If you are currently enrolled and you select "Waive" you will be REMOVED from the insurance
If you are currently enrolled and you select "Waive" you will be REMOVED from the insurance