Get Birth Of A Child - Broward County Public Schools - Broward K12 Fl

Filling out the BIRTH OF A CHILD form for Broward County Public Schools is an important step for new parents looking to enroll their child in the appropriate health plan. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to submit the BIRTH OF A CHILD form online.

1. Press the ‘Get Form’ button to access the BIRTH OF A CHILD form and open it in your preferred document editor.
2. Provide your personal data, including your personnel number, full name, current address, social security number, and home phone number.
3. Select the health plan for your newborn by marking the appropriate option. You may choose between different options such as HMO-HIGH, HMO-LOW, and Kids Plans.
4. Indicate whether you have other children enrolled in the Kids Plan by selecting 'Yes' or 'No.'
5. Fill in the effective date, which should be the date of birth of your newborn.
6. Enter the full name, sex, date of birth, and social security number of your newborn.
7. Record the name and contact number of your child's physician.
8. Review the statement regarding coverage and ensure you understand the responsibilities related to premium payments.
9. Sign and date the form to confirm that the information provided is accurate and complete.
10. Submit the completed form to the Benefits Department via mail or fax as specified. Ensure submission within the required 31-day timeline to avoid any loss of benefits.

Complete the BIRTH OF A CHILD form online today to ensure your newborn is properly enrolled in health coverage.