Insurance Coverage Inquiry

Insurance Coverage Inquiry
Open Enrollment for insurance for Bucciferro Family McDonald's employees begins on 11/7/24 and closes 12/11/24 for January 2025 enrollment. If you are interested in finding out information about possible benefits, please complete the information below and you will receive a response in your email within 7 business days. Please click this link to view our benefits.To explore alternative low-cost options for health insurance coverage go to www.healthcare.gov
Iron Arch McDonald's Health Insurance Benefit Notice
Employee Name*

First NameLast Name
By signing, I have reviewed a copy of the insurance benefit notice. I also understand that I am being offered insurance by Iron Arch Management and that it is my responsibility to alert my manager or theIron Arch Management office of my interest in receiving insurance based on the current policy and fill out the appropriate form(s) within 30 days. I understand that after 1 year of employment and during the annual open enrollment period, I may be required to update my interest in insurance provided by IronArch Management. By not alerting the office to my interest in insurance, I understand I will be declining this benefit.*

Clear

General Info
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth*

MonthDayYear
Legal Gender*

MaleFemale
What area is your restaurant in?*

Madison areaBeloit areaRockford areaHuntley area
Madison restaurant*
Beloit restaurant*
Rockford restuarant*
Huntley restaurant*
Employee Email address*
Date of Hire*

MonthDayYear
Your Position*
What coverage are you looking for? Select One

MedicalComprehensive Dental (Basic, restorative, major, and orthodontic care)Preventative Dental (Regular check ups, cleanings, and x-rays)VisionMedical/Comprehensive Dental/VisionMedical/Preventative Dental/VisionMedical/Comprehensive DentalMedical/Preventative DentalMedical/VisionComprehensive Dental/VisionPreventative Dental/VisionSupplemental or VoluntaryOther
What Supplemental/ Voluntary coverage are you looking for?
What type of coverage would you like for your supplemental plan?

Employee OnlyEmployee and SpouseEmployee and Children or Family
We're sorry, this supplemental/Voluntary plan is only availble to Employees only.
We're sorry, this supplemental/Voluntary plan is only availble for employee only or employee and spouse.
Medical/Dental /Vision Coverage Type*
Please select which coverage you are looking for more information on.*

MedicalDentalVision
Should be Empty:

General Info