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Original Effective Date

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  Enrollee: DIV: ELK Group: 22222 Insured ID:
         
Add Employee
 
Step 1   Enter Original Effective Date for Employee and Continue.


Original Effective Date      /   / 



  
 
 

On this page, you enter the date that this enrollment will be effective.
 
  1. Enter 02 01 2002 in the required Original Effective Date field on the sample page.
  2. Click the Continue button to go to the next page.
 
  Note: Beginning on this page, information such as enrollee name, division, group, and insured ID number displays when available.