Get Proof Of Health Insurance Form

This guide provides a clear, step-by-step approach to completing the Proof Of Health Insurance Form online. Whether you are enrolling in coverage or providing existing insurance details, these instructions will help you navigate the process with ease.

Follow the steps to successfully complete your form.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin by filling out the 'Student Name' section, ensuring that your full legal name is entered as it appears on official documents.
3. Proceed to Section I if you already have health insurance coverage. Fill in your Social Security Number and Student ID Number accurately.
4. In Section I, provide the name and address of your insurance company. Ensure that the policy number, certificate number, and group number are entered correctly.
5. Indicate the name of the insured and their relationship to you, such as 'parent' or 'guardian.'
6. Enter the expiration date or any terms regarding when your coverage will cease, making sure this information is accurate.
7. Sign the form in the designated area to certify that the information provided is accurate to the best of your knowledge.
8. If you do not have any existing health insurance, complete Section II by signing the statement affirming your need for the University’s insurance plan and agreeing to the premium payment.
9. After filling out the required sections, review your entries to ensure all information is correct.
10. Once finalized, save any changes made to the form, and consider downloading, printing, or sharing it as necessary for your records.

Complete your Proof Of Health Insurance Form online today for a seamless enrollment process.