Get Domestic Partner Affidavit - Anthem

Completing the Domestic Partner Affidavit - Anthem online is a necessary step for domestic partners seeking to enroll in health benefits. This guide provides a straightforward, step-by-step process to ensure that you can fill out the affidavit accurately and efficiently.

Follow the steps to fill out the Domestic Partner Affidavit - Anthem.

1. Begin by locating and clicking the ‘Get Form’ button to access the Domestic Partner Affidavit.
2. In Section 1, enter the employee information: fill in your last name, first name, plan identification number, group name, group number, and the date.
3. Proceed to Section 2, where you will make a declaration of fact. Ensure you carefully read all statements under this section before affirming your agreement by checking the relevant boxes.
4. Make sure both partners fill in details, including confirming they are not legally married or in a civil union and have resided together for the required time.
5. In Section 3, indicate your agreement to notify the group of any changes in your domestic partnership status and understand the implications of such changes.
6. Both partners should sign the affidavit, print their names, provide their addresses, and include their email addresses where necessary.
7. Finally, review the completed affidavit for accuracy, and ensure all necessary signatures are present before finalizing your submission.
8. Once you are satisfied with the application, you can save changes, download, print, or share the completed form as needed.

Complete your Domestic Partner Affidavit - Anthem online today to ensure your eligibility for benefits.