Purdue University Working Spouse Premium Waiver Form Printed Employee Name Printed Spouse Name This form must be completed and uploaded into Benefitfocus no later than December 2, 2019, ONLY if you.
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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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Get answers to your most pressing questions about US Legal Forms API.
What is USC spousal surcharge?
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.
How do you get around spousal surcharge?
To avoid paying the surcharge, your spouse or partner can enroll in his or her employer's medical plan. You'll want to compare coverage and total costs both ways to see what makes sense for your family.
What is the working spouse rule?
The Plan's Working Spouse Rule states that, if your spouse is working for an employer who offers a health plan, the Plan requires them to enroll in that employer-sponsored coverage to be eligible for Plan coverage. Your spouse must confirm whether they have access to and are enrolled in their employer's health plan.
What is a working spouse premium?
The spouse premium surcharge is a monthly charge in addition to your regular medical coverage contribution/premium for a spouse who is working or retired and who is eligible for medical coverage through their employer or former employer.
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