Get Soma12-13 Ap - Website

Filling out the SOMA12-13 AP - Website form can be straightforward when you have clear guidance. This guide will walk you through each section of the form to ensure that you complete it accurately and efficiently.

Follow the steps to complete the SOMA12-13 AP - Website form online.

1. Press the ‘Get Form’ button to acquire the form and access it in the editor.
2. Begin with the ‘Membership Type’ section. Choose the appropriate membership option by checking the corresponding box for either 'Osteopathic Medical Student' or 'Associate Member.'
3. In the ‘SOMA College Health Insurance Plan’ section, fill in your social security number, last name, first name, middle initial, birthdate, and email address.
4. Complete the address section by entering your city, state, and zip code. Also, provide your cell phone number and telephone number.
5. Indicate your year in the program by selecting from the options provided: OMS I, OMS II, OMS III, or OMS IV.
6. Specify your marital status by selecting one of the options: Single, Married, or Domestic Partner. If you have dependents, list their names and details in the section provided.
7. Choose your monthly premium option based on your status as a student and any dependents you wish to cover. Select the appropriate plan: Co-Pay Plan or High Deductible Plan (HDHP), and indicate if you need vision or dental coverage.
8. Calculate the total premium due by summing the medical, vision, and dental costs, then fill in this total in the space provided.
9. Authorize billing by inputting your credit card details, including account number and expiration date. Remember to read the cancellation policy.
10. Sign and date the form in the designated areas to validate your enrollment request.
11. Once completed, save your changes. You may also choose to download, print, or share the form based on your requirements.

Start filling out the SOMA12-13 AP - Website form online today to ensure your health insurance coverage.