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                Get Ps 451
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How to fill out the Ps 451 online
The Ps 451 is a crucial document for enrollees requesting continuation of health insurance coverage for their dependents who are disabled and unable to support themselves. This guide provides a clear and supportive step-by-step approach to help you navigate the form effectively.
Follow the steps to complete the Ps 451 online
- Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
 - Complete Part A of the form, which requires the enrollee's name, health insurance ID number, home address, and request for continuation of NYSHIP coverage for the dependent. Ensure you check the relationship of the dependent.
 - In Part B, your employing agency will fill in the required information including effective date of insurance and verify the dependent’s eligibility. Ensure they complete this part before moving on.
 - Leave Part C blank. This section will need to be completed by the health maintenance organization or United Healthcare after receiving input from the attending physician.
 - After completing all parts, either the enrollee or the attending physician should mail the completed form to the appropriate carrier, either United Healthcare or directly to the HMO.
 - Ensure to keep a copy of the completed form for your records and any additional documentation needed.
 
Start filling out the Ps 451 online today to ensure your dependent's health insurance coverage continues seamlessly.
That I am _______________ of ______________, Son/D/W/B of ___________________. That my _______________(Relationship with Applicant) __________________(Name) expired on _____________(Date of Death) at ___________(Name of place). That I am swearing this Affidavit to establish relationship with my ______________.
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