Election Identifier
Specify the exact name and citation of the election (Form I-18 or internal election code). Use the same terminology that appears on the original election document to avoid ambiguity.
A properly prepared notice creates an authoritative record showing when an election ended, reduces ambiguity for counterparties or regulators, and helps prevent unintended obligations or administrative errors. It supports auditability and preserves evidence of intent.
Organizations, authorized representatives, and compliance teams commonly prepare the notice when an election under Form I-18 is ended.
Keep a copy of the signed notice in official records and distribute it to all affected parties to ensure consistent implementation.
Specify the exact name and citation of the election (Form I-18 or internal election code). Use the same terminology that appears on the original election document to avoid ambiguity.
State the discontinuance effective date using MM/DD/YYYY. This date determines when any election-based rights or obligations end and supports accurate recordkeeping.
List full legal names of all parties or entities affected, including employer, plan administrator, or beneficiary names, to ensure the notice binds the correct legal actors.
Briefly state the factual reason for discontinuance and cite the internal policy, statute, or delegated authority that permits the party to withdraw the election.
Include printed name, title, signature, and date for each authorized signatory. Indicate the capacity in which each person signs (e.g., authorized agent, plan trustee).
Note recipients, delivery method, and confirmation of service (email timestamp, receipt, or certified mail) to document notice delivery and receipt.
| Field | Configuration |
|---|---|
| Signature Order | Sequential or parallel as required |
| Authentication | Email link, SMS code, or advanced auth |
| Retention | Automatic archive to compliance folder |
| Audit Trail | Enable IP, timestamp, and action logs |
Use an eSignature platform that meets your required authentication strength and audit-trail needs.
Ensure the selected platform supports retention, audit trails, and any industry-specific compliance such as HIPAA or 21 CFR Part 11 where applicable.
Some recipients confirm receipt within 24–72 hours
Allow 7–14 business days for payroll or benefits updates
If filing required, expect 30–60 day review periods
Allow reasonable time for dispute or correction
Retention begins on the effective discontinuance date
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | 7-day free trial, no credit card required | Varies by vendor | Varies by vendor | Varies by vendor | Varies by vendor |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |
A payroll team ends an employee benefits election after eligibility changes
A plan administrator withdraws an earlier plan opt-in election due to administrative error