Get Working Spouse Verification Form - New Jersey Carpenters Funds

Completing the Working Spouse Verification Form is essential for maintaining health coverage under the New Jersey Carpenters Funds. This guide provides clear instructions for filling out the form online to ensure a seamless submission process.

Follow the steps to complete the form accurately and effectively.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal details: fill in the member's name and Member ID number, as well as the spouse's name.
3. Select either Section I or Section II based on your spouse's health coverage situation. Ensure that you only complete the section that applies.
4. For Section I: If your spouse has group health coverage, provide all necessary details including the insurance company name, phone number, policy ID, and original effective date. Indicate the coverage types by selecting options.
5. For Section II: If your spouse does not have group health coverage, check the appropriate box explaining why. Provide any additional requested information such as termination date or employer information if applicable.
6. If your spouse is currently employed but does not have coverage, provide employer verification details if any box from A to F in Section II is checked.
7. Both the member and spouse must sign in the authorization section, confirming the accuracy of the information provided. Include daytime phone numbers and dates.
8. Review all information for accuracy before finalizing. This ensures that the form meets the requirements for verification.
9. Once completed, save changes and download or print the form for submission. Use the self-addressed envelope provided to return it to the New Jersey Carpenters Health Fund.

Complete the Working Spouse Verification Form online today to ensure continued health coverage.