Get 6953 R8 Nj Ind App Ohp.doc

Filling out the 6953 R8 NJ Individual Application/Change Request Form for Oxford Health Plans can feel overwhelming. This guide provides clear, step-by-step instructions to help you navigate each section of the form online, ensuring that you complete it accurately and efficiently.

Follow the steps to successfully fill out the form.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. In Section A, you will indicate the type of activity you are applying for. Check all boxes that apply such as 'Add Spouse' or 'Remove Dependent Child' and provide relevant effective dates and reasons.
3. Section B requires you to fill in your personal information. Include your name, social security number, birthdate, and confirm your residency in New Jersey.
4. In Section C, indicate whether you are covered under other health coverage. If applicable, provide details about previous coverage, including policy numbers and termination dates.
5. Section D is where you identify any other individuals for whom you are changing coverage. List their names and relationship to you, and specify whether you are adding or removing coverage for them.
6. Complete Section E and F with additional information regarding your spouse, domestic partner, or children, if their addresses differ from yours. Make sure to provide any necessary explanations.
7. In Section G, choose your race/ethnicity only if you are comfortable doing so. This section is appreciated but not mandatory.
8. Finally, in Section H, indicate your preferred payment method, and ensure that you sign in Section I as the applicant, confirming that the information provided is true and complete.
9. Once all sections are filled out, you can save your changes, download the completed form, and print it for your records.

Complete your 6953 R8 NJ Ind App OHP.doc online today to ensure timely processing of your application.