Get Enrollment Form - Central Methodist University - Centralmethodist

This guide provides a comprehensive overview of the Enrollment Form for Central Methodist University, designed to assist users in filling it out accurately and efficiently. Follow the instructions carefully to ensure all necessary information is provided.

Follow the steps to successfully complete the enrollment form.

1. Press the ‘Get Form’ button to access the Enrollment Form and open it in your preferred editor.
2. Begin with Section 1, which requires employer information. Fill in the employer name, group number, address, and life division number as applicable.
3. Proceed to Section 2 to indicate the reason for your application. Choose from options like new enrollment, COBRA, or qualifying event, and provide the relevant details.
4. In Section 3, if applicable, outline the status change or event regarding any dependents. Include necessary dates and documentation for changes such as marriage or adoption.
5. Complete Section 4 by selecting your desired plan type and coverage. Be sure to indicate if you are waiving coverage.
6. Fill out Section 5 with your personal information including name, date of birth, social security number, and contact details.
7. In Section 6, provide details about any dependents you wish to enroll. List their names, dates of birth, and social security numbers as required.
8. Complete Section 7 if you selected life and disability insurance in Section 4. Specify coverage amounts and beneficiary details.
9. Follow with Section 8, where you must disclose any other health coverage you or your dependents may have.
10. Provide prior health coverage details in Section 9 if applicable, including any prior policies and termination reasons.
11. Carefully read and acknowledge the terms in Section 10 before signing the application in Section 11.
12. If you need to waive coverage, complete Section 12 and provide the necessary signatures and reasons.
13. After filling out the form, you can save your changes, download a copy, print it, or share it with your employer as needed.

Take the next step in your education by completing your Enrollment Form online today!