Get Udel 1112 - Applications 070511 - Udel

This guide provides a comprehensive overview of how to complete the UDel 1112 - Applications 070511 - Udel form online. By following these instructions, users can efficiently navigate each component of the application and ensure all necessary information is accurately provided.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application form and access it in your preferred format.
2. Begin by filling out Part A - Personal Information. Provide your University ID number, last name, first name, middle initial, gender, street address, apartment or floor number, date of birth, city, state, zip code, status, and email address.
3. Proceed to Part B - Dependent Information. Here, you can include your spouse and/or eligible children. Fill in the dependent's last name, first name, middle initial, gender, and date of birth as applicable.
4. Move to Part C - Other Insurance Information. Indicate if you or any dependents have coverage from other health insurance by circling 'Yes' or 'No.' If applicable, provide the name of the insurance company, policyholder details, submission address, and policy identification number.
5. Complete Part D - Terms of Agreement & Signature. Read through the terms carefully, then sign and date your application to confirm your understanding and agreement to the outlined terms.
6. In Part E - Plan Options, select your preferred insurance plan by placing a check mark in the corresponding box next to the plan you have selected.
7. Finally, complete Part F - Payment & Mailing Instructions. If paying online, ensure you do so during enrollment periods. For paper applications, prepare a check or money order and submit your completed form to the specified address.
8. After reviewing all entered information for accuracy, submit the form. Save changes, download, print, or share the application as required for your records.

Complete your application online today for efficient processing and confirmation of your health insurance coverage.