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Get Purdue University Working Spouse Premium Waiver Request 2019
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How to fill out the Purdue University Working Spouse Premium Waiver Request online
Completing the Purdue University Working Spouse Premium Waiver Request online is essential for users looking to waive the working spouse premium for medical coverage. This guide provides clear instructions to help ensure all necessary information is accurately submitted.
Follow the steps to successfully complete your waiver request.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the printed employee's name in the designated field, ensuring correct spelling for accuracy.
- Next, input the printed spouse's name in the corresponding field, verifying it matches official documents.
- Review the criteria for the waiver, confirming that at least one of the specified conditions regarding the spouse’s employment status is applicable.
- For the Employer Certification section, provide the employer’s name and ensure that this section is completed and signed by the spouse’s employer.
- In the Employer Certification section, check the box indicating whether the spouse is eligible for medical insurance under a group plan and confirm enrollment for the year.
- Complete the Employee Certification section by signing the document and dating it, ensuring you understand the implications of providing accurate information.
- Remember that if your spouse is self-employed, they or a representative from their company should complete the necessary sections.
- Finally, review all entries for accuracy, then save your changes, and download or print the completed form as needed.
Take the next step towards managing your benefits by completing your Purdue University Working Spouse Premium Waiver Request online today.
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If your plan covers a spouse who has access to medical insurance through his/her employer, a surcharge of $100 per month will be applied to your paycheck contributions for your medical plan.
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