4 MY HR
HOW TO PRE-PAY INSURANCE
CALL THE 4MYHR SERVICE CENTER
TO REQUEST A
“HEALTH & INSURANCE PRE-PAYMENT NOTICE”
To Request the Health & Insurance Pre-Payment Notice Form:
Click on “My Pay & Benefits” (Grey tab at top)
Click on Health & Insurance
Click on Learn About (Black Tab) underneath Health & Insurance.
Click on “Forms Request”
Click on the last link at the bottom of the page; “Health and Insurance Pre-Payment Notice” and a form will be mailed directly to your home address.
You may make copies of the form in order to make multiple payments
You must send the “Health & Insurance Pre-Payment Notice” form with your check to the 4myHR Service Center.
**See below for picture of Forms Requests.**
*See below for Form Example.**