Get Hpbeneficiary Card-color-5.doc - Mpiphp

Completing the HPBeneficiary Card-color-5.doc - Mpiphp is an essential process for enrolling in the Motion Picture Industry Health Plan and designating beneficiaries for life insurance. This guide provides clear, step-by-step instructions to ensure that you can successfully fill out the form online.

Follow the steps to complete the form accurately and efficiently.

1. Click the ‘Get Form’ button to access the HPBeneficiary Card-color-5.doc - Mpiphp and open it in your editing tool of choice.
2. Begin by entering your personal information in the designated fields, including your social security number, last name, first name, middle initial, and date of birth. Ensure that you select your gender as either 'Female' or 'Male'.
3. Provide your mailing address, including the city, state, and ZIP code. It is important to include a current daytime phone number for further communication, if necessary.
4. Indicate your marital status by checking the appropriate box, selecting from options such as 'Divorced', 'Widowed', 'Married', or 'Single'. Also, include relevant dates for marriage or divorce as applicable.
5. List all eligible dependents in the spaces provided. You must include the social security numbers and dates of birth for each dependent. Consult your summary plan description for the documents required to establish eligibility.
6. Carefully complete the life insurance section by designating your primary and contingent beneficiaries. For each beneficiary, provide their last name, first name, middle name, relationship to you, age, and mailing address. Decide if the benefit will be shared and indicate 'Yes' or 'No'.
7. After filling out all fields, review your entries for accuracy and completeness. Make sure to certify the information by signing the form. The signature is required and must be accompanied by the date of signing.
8. Once you have completed and reviewed the form, save your changes. You can then download, print, or share the form as needed before submitting it to the Plan Office.

Ensure your benefits are secure by completing the HPBeneficiary Card-color-5.doc - Mpiphp online today.