Get Benefits Plus Learning Center Community Service Society Of New...

This guide provides clear, step-by-step instructions on how to fill out the Benefits Plus Learning Center Community Service Society Of New... form online. Follow these detailed directions to ensure you complete the application accurately and efficiently.

Follow the steps to complete the enrollment application.

1. Click the ‘Get Form’ button to access the application and open it in your editing tool.
2. Complete Section I, which requires general information such as the veteran's name, social security number, and date of birth. Make sure to include your complete address and contact information.
3. In Section II, provide military service information including the last branch of service and discharge details. If available, attach your discharge papers to expedite processing.
4. Fill out Section III with your insurance information. List all health insurance providers covering you, including a spouse's plan if applicable.
5. Proceed to Section IV to include dependent information. List spouse and children, their birth dates, and any expenses you covered for your dependents.
6. In Section V, report previous year's gross annual income for you, your spouse, and dependent children, ensuring you include all applicable income amounts.
7. Complete Section VI by detailing non-reimbursed medical expenses paid during the previous year, as well as any funeral or burial expenses incurred.
8. Fill in Section VII with your financial disclosures, including net worth calculations. Exclude your primary residence and personal household items.
9. Read Section VIII carefully, then sign and date the form. Ensure that your signature matches the requirements; if signing with an 'X', include witnesses as necessary.
10. After completing the form, attach any supporting materials required, then submit the original application to the Health Eligibility Center at the provided address.

Complete your enrollment application online today and ensure you have access to your health benefits.