Get Mnsure Form Yy: Authorized Representative Form

MNsure Form YY allows individuals to give permission to a representative to act on their behalf regarding eligibility and enrollment. This guide provides a clear, step-by-step approach to filling out the form online, ensuring users can complete the process with confidence.

Follow the steps to complete the MNsure Form YY online:

1. Click ‘Get Form’ button to obtain the MNsure Form YY and open it in your editor.
2. In Part 1, you will input your name, street address, phone number, and the name of the person you are authorizing. Ensure that you print the first and last name of the authorized representative clearly.
3. Review the information provided in Part 1 carefully. Make sure you understand the responsibilities of the authorized representative, including their ability to access your eligibility and enrollment information.
4. Sign and date the form in the designated area at the end of Part 1.
5. In Part 2, the authorized representative should fill in their details, including their name, contact information, and their address.
6. The authorized representative must also sign and date the form, ensuring all information is accurately filled.
7. After completing both parts of the form, review the entire document for accuracy before finalizing.
8. Once satisfied, you can save changes, download the completed form, print it, or share it as necessary.

Complete your documents online today to ensure a smooth process.