Get Highmark Enr-163 2016-2025

The Highmark ENR-163 is a vital document for making personnel changes related to health coverage. This guide provides comprehensive and user-friendly instructions for filling out the form online, ensuring you complete it accurately and efficiently.

Follow the steps to fill out the Highmark ENR-163 online effectively.

1. Press the ‘Get Form’ button to access the Highmark ENR-163 form in your preferred online editor.
2. Begin by filling out the employee or contract holder information, including your effective date and employer/group name. Be sure to indicate your reason for completion by selecting the appropriate box.
3. If you have dependents to report, address that section next. Here, you will need to indicate any dependent additions or removals due to significant life events, choosing from the options provided.
4. For dependent changes, enter details such as the first name, middle initial, last name, gender, date of birth, and relevant physician records as needed.
5. In the other changes section, report any additional updates like a new name, address, or changes to Medicare eligibility if applicable.
6. Fill out the section for other health insurance coverage, providing the name of the insurance carrier, group number, effective dates, and policyholder details as required.
7. Lastly, review all entered information for accuracy, then sign and date the form at the end. Ensure all necessary attachments, such as marriage certificates or custody papers, are included.
8. Once completed, you can save any changes, download, print, or share the form as necessary.

Start filling out the Highmark ENR-163 online now to ensure your health coverage changes are processed promptly.