Get Enter Request Below - Stony Brook University - Naples Cc Sunysb

Filling out the ENTER REQUEST BELOW form designed for Stony Brook University's Naples Campus is essential for graduate student employees and their dependents seeking to manage health insurance coverage. This guide will provide clear, step-by-step instructions to help ensure a smooth completion of the form.

Follow the steps to successfully complete your online form.

1. Select the 'Get Form' button to retrieve the form and open it for editing.
2. Begin by entering your last name in the designated field, followed by your first name. This information identifies you within the system.
3. Fill in your mailing address, including city, state, and ZIP code. This allows the university to send important correspondence regarding your request.
4. Provide your date of birth, utilizing the specified format, and include your social security number for identification purposes.
5. Indicate your preferred contact number by filling in your home phone number, work phone number, and cell phone number as applicable.
6. Choose your department name and ZIP code from the provided options to ensure accurate departmental tracking.
7. Select your marital status and sex by checking the corresponding boxes labeled married/single and M/F.
8. Mark the option related to health insurance enrollment within the last 28 days if applicable, and choose your visa type from the designated options.
9. Indicate the type of request you are making, such as adding or deleting a dependent, requesting coverage for dependents, or changing coverage type.
10. Complete the dependent information section for each individual you are enrolling or changing. Provide their last name, first name, sex, date of birth, relationship, and social security number.
11. Review your entries for accuracy, then provide your signature and the date to verify the information submitted.
12. Once all fields have been completed and verified, you can save changes, download, print, or share your form as needed.

Submit your completed request online to ensure timely processing of your health insurance coverage.