Get Anthem Application - Local Union 248

Filling out the Anthem Application for Local Union 248 is a key step in securing health and life insurance benefits. This guide provides clear and detailed instructions to help users navigate the application process online, ensuring all necessary information is accurately provided.

Follow the steps to complete the Anthem Application online.

1. Press the ‘Get Form’ button to retrieve the form electronically and open it in your chosen editor.
2. Begin with Section 1: Employer/group use. Fill in the required fields such as employer name, address, group number, and effective date.
3. Move to Section 2: Reason for application. Indicate the type of application, whether it’s a new enrollment, rehire, or adding a dependent.
4. If applicable, complete Section 3: Status change/event. Fill in the event date and the type of event such as marriage or loss of coverage.
5. Proceed to Section 4: Plan/type of coverage. Specify the desired coverage, including options for medical, dental, and vision, and indicate if waiving coverage.
6. In Section 5: Employee information, input personal details like your name, date of birth, contact information, and Social Security number.
7. Section 6: Family information must be filled if enrolling dependents. List dependents you wish to include, providing necessary details.
8. If you selected life and disability insurance in Section 4, fill out Section 7 with relevant information regarding your coverage choices.
9. Section 8: Other health coverage requires details of any other health insurance you or your dependents currently have.
10. Review Section 9: Significant Terms, Conditions and Authorizations carefully before signing. Ensure you understand all terms stipulated.
11. Sign and date in Section 10 to confirm your application is accurate, then proceed to Section 11 if you are waiving coverage options for any dependents.
12. Once all sections are completed, save your document, and then download, print, or share the form as needed.

Take the first step towards securing your benefits by completing the Anthem Application online today.