Get Dependent Life Insurance Enrollment Form 2011 Open ...

Filling out the dependent life insurance enrollment form is an essential process for securing coverage for your dependents. This guide will walk you through each section of the form, ensuring you provide the necessary information accurately and efficiently.

Follow the steps to complete the form online:

1. Click the ‘Get Form’ button to access the dependent life insurance enrollment form and open it in your preferred editing environment.
2. Begin by entering your name in the designated fields, writing your last name, first name, and middle name accurately.
3. Proceed to input your employee number, ensuring the number you provide matches your employment records for verification purposes.
4. In the dependent life insurance section, note that premiums for policies valued at $10,000 per dependent are paid by St. Jude Children’s Research Hospital.
5. List your dependents, starting with your spouse. Include their full name and select the appropriate options to denote if you are adding or deleting them from the coverage.
6. For each child, fill in their full name and specify their relationship to you by choosing from the options such as son, daughter, stepson, or stepdaughter. You may also provide an alternative descriptor if needed.
7. Indicate whether each child is a full-time student by selecting 'yes' or 'no' in the corresponding section.
8. For additional dependents, repeat steps 5 through 7 as needed, including only eligible persons such as your spouse and children ages 7 days to 21 years, or to age 25 if they are full-time students.
9. If you have no eligible dependents, check the box provided to indicate this status.
10. Complete the social security number and date of birth sections as required, ensuring accuracy to prevent issues with enrollment.
11. Sign and date the form to authorize your application, confirming accuracy and acknowledgement of any taxes that may be deducted from your earnings.
12. After reviewing the completed form for accuracy, save your changes and prepare to download, print, or share the form as needed.

Complete your dependent life insurance enrollment form online today!