Health Insurance - DECLINE Forms

October 4, 2016

WMSD Employees:

The Affordable Care Act (ACA) requires the district to have decline forms on file for each employee who does not enroll within the health care insurance offered through West Memphis School District.  If you are not enrolled or do not plan to enroll in the insurance offered through WMSD this October 1-12, 2016, please complete, print, and return this form via school mail.  Forms must be received at the WMSD Central Administration Office by 4pm on October 12, 2016.

Letters with forms are also being distributed today to employees not currently enrolled via school mail.  You can wait for letter or print the form in link above, complete, and return via school mail.

Thank you for your cooperation,

Connie Overall
870-735-1915
coverall@wmsd.net