Get 1199seiu Benefit Funds Afeli01 2020-2025

Filling out the 1199SEIU Benefit Funds AFELI01 form is an essential step in ensuring your young adult dependent receives the necessary coverage. In this guide, we provide clear and supportive instructions to help you successfully complete the form online.

Follow the steps to complete the 1199SEIU Benefit Funds AFELI01 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide your member information by entering your full name, member ID number, and selecting the benefit fund(s) you are enrolled in by checking the applicable boxes.
3. Fill in your current address, city, state, zip code, and a contact number where you can be reached. Also, include an email address for additional communication.
4. Next, provide information about your young adult dependent by filling in their full name and social security number. Indicate their gender by selecting ‘Male’ or ‘Female’.
5. If your dependent’s address differs from yours, fill in their address, city, state, zip code, and their contact numbers.
6. Address the question regarding the young adult's health insurance through another parent. If applicable, provide the other parent’s full name, date of birth, employer’s name, and their address information.
7. Indicate the types of coverage your young adult dependent has access to by checking all applicable options such as medical, hospital, prescription, dental, and vision.
8. Repeat the previous step for the information regarding your dependent's employer health plan, if they have one. Provide similar details as required.
9. Complete the section regarding any spousal health plans, if relevant. Again, provide all requested information about the spouse's coverage.
10. Review all completed fields for accuracy and clarity to ensure all necessary information is provided.
11. Print out the completed form. Both you and your young adult dependent are required to sign and date the document in the designated areas before submission.
12. Mail the signed form to the address provided for the 1199SEIU Benefit Funds, ensuring prompt and accurate processing of your request.

Complete your documents online today to ensure your young adult dependent receives the necessary health coverage.