Get Highmark Enr-163 2020-2025

The Highmark ENR-163 is an essential form for individuals making changes to their health insurance coverage. This guide provides a clear and systematic approach to completing the form online, ensuring you understand each section and requirement.

Follow the steps to complete the Highmark ENR-163 online.

1. Press the ‘Get Form’ button to access the Highmark ENR-163 and open it for editing.
2. Begin by entering your employee or contract holder information. Fill out the effective date, employer or group name, and the group number.
3. Indicate the reason for completing the form, such as cancelling the entire contract or making dependent changes due to events like marriage or birth.
4. For adding dependents, select the appropriate life event and enter the date of that event. If applicable, provide any necessary attachments.
5. For cancelling dependents, indicate the reason and the date of the event. Include documentation if necessary.
6. If applicable, provide information on your current health coverage under other plans, including the insurance carrier name and policy numbers.
7. Complete the covered dependent information section, ensuring to include all relevant personal details, including Social Security numbers, birth dates, and medical product selections.
8. In the final section, provide your signature and date to authorize the information provided, affirming its accuracy. Consider saving, downloading, printing, or sharing the completed form as required.

Complete your documents online to ensure timely processing.