Get Spouse Form 1 Completed Set By Rwittmann Coordination Of ... - Ww Mpiphp

Filling out the Spouse Form 1 is an essential step in ensuring proper coordination of benefits with the Motion Picture Industry (MPI) Health Plan. This guide provides clear and concise instructions for users to complete the form accurately online, ensuring a smooth submission process.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to access the form and open it in the designated editor.
2. Begin with the 'Participant Information' section. Fill in your last name, first name, middle initial, date of birth, phone number, and social security number as instructed.
3. Indicate if you have any other insurance plans besides the MPI Health Plans. Select 'Yes' or 'No' and provide details about any other group or individual insurance plans if applicable.
4. Complete the 'Spouse Information' section by entering your spouse's last name, first name, date of birth, middle initial, and social security number.
5. Indicate your spouse's employment status by checking the appropriate box. If your spouse is not employed, proceed to sign and date the form, then return with Form 3, Declaration.
6. If your spouse is employed, answer whether group health benefits are available. If 'Yes', provide information regarding the type of coverage available.
7. Sign and date the form certifying the accuracy of the information provided. Ensure all sections are filled out correctly to avoid delays.
8. If there are any changes to the information, a new form must be submitted within 30 days. Save any changes or options to download, print, or share the completed form.

Complete your forms online today to ensure your benefits are well-coordinated.