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Get Famis Select Form
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How to fill out the FAMIS Select Form online
FAMIS Select is a program designed to provide families with children enrolled in FAMIS increased flexibility in managing their healthcare coverage. This guide will walk you through each component of the FAMIS Select Form, ensuring you fill it out accurately and efficiently online.
Follow the steps to complete the FAMIS Select Form online.
- Press the ‘Get Form’ button to access the FAMIS Select Form online and open it in your preferred editor.
- In Section 1, provide your personal information as the policyholder. Fill in your name, address, and phone numbers. Social Security Number is optional.
- In Section 2, enter details regarding your health insurance policy. Indicate whether it is an employer’s plan or a private plan, and include the effective date and policy number. Check the benefits covered by your insurance policy.
- In Section 3, list all family members who are covered under your plan. Include their names, dates of birth, and relationship to you. Check if each family member is approved by FAMIS.
- In Section 4, input the amounts you are paying for health, dental, and vision insurance. Indicate your payment frequency by checking the appropriate box.
- After completing all sections, ensure the application is signed by the policyholder. If applicable, the custodial parent must also sign.
- Finally, save your changes. You have the option to download, print, or share the completed form as needed.
Begin the process of completing your FAMIS Select Form online today.
To enroll in the Virginia Health Insurance Marketplace, visit the official Healthcare site during the open enrollment period. You’ll need to provide some personal information, including income and household size. If you have children and are considering FAMIS, the Famis Select Form can assist you in understanding how that may affect your overall health insurance options.
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