Get I Have Selected The Following Health Insurance Plan

Completing the ‘I Have Selected The Following Health Insurance Plan’ form online is a straightforward process. This guide will walk you through each step, ensuring you can fill out the form accurately and with confidence.

Follow the steps to complete your health insurance plan selection.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Enter your full name in the designated field. This should be your legal name as it appears on official documents.
3. Select the health insurance plan you have chosen by checking the appropriate box: either GuideStone or Other. If you select Other, please enter the provider name in the provided field.
4. Enter your policy number in the designated field, followed by the effective date of your insurance coverage.
5. Complete the sections for Last Name, First Name, Telephone number, and MBTS Email address.
6. Add your signature to the designated field, confirming your selections.
7. Choose your submission method: you can either email the completed form along with the required documentation to cmack@mbts.edu or fax it to 816-414-3863.
8. If you have not selected an insurance plan, check the box indicating this decision and sign in that section.
9. Review all entries for accuracy before submitting your form. Once reviewed, save your changes, download a copy for your records, print the form, or share it as required.

Complete your health insurance plan selection online now to ensure you meet your coverage requirements.