Get Pehp Online Tools - Weber State University

This guide provides step-by-step instructions on how to fill out the PEHP Online Tools used by employees at Weber State University. With clear directions, users can effectively navigate the form sections and ensure accurate submissions.

Follow the steps to complete the online form seamlessly.

1. Click ‘Get Form’ button to retrieve the medical enrollment and change form and open it in the editor.
2. Fill in your personal information in Section A. This includes your name, Social Security number, birth date, and contact information. Ensure all details are accurate to avoid delays in processing.
3. Indicate your eligibility and coverage type by checking the appropriate box, whether it is for individual, employee plus one, or family coverage.
4. In Section B, provide information for any dependents you wish to add. This entails listing their names, birth dates, and identifying relationship codes (such as spouse or child).
5. If applicable, complete Section C to disclose any additional health insurance coverage for yourself or your dependents. This helps in coordination of benefits.
6. Use Section D to explain any unique situations about your dependents that need further clarification. This may include custody issues or other relationships.
7. In Section E, read and confirm the employee agreement, ensuring you understand your responsibilities related to dependent eligibility and claims.
8. Sign and date the form at the bottom of Section E to validate the information provided.
9. Finally, save changes to your form, then download, print, or share the form as necessary.

Start completing your PEHP Online Tools form now for efficient management of your healthcare benefits.