Get Amendment Form For International Health Plan - Css Versicherung

Filling out the Amendment Form for the International Health Plan - CSS Versicherung online is a straightforward process that ensures your health insurance details are current and accurate. This guide provides a clear, step-by-step approach to assist you in completing the form efficiently.

Follow the steps to complete the form successfully.

1. Click the ‘Get Form’ button to retrieve the Amendment Form and open it in your preferred editing interface.
2. Begin by entering your personal data in the designated fields: fill in your client number, first name, last name, and correspondence address. Include the street address, any additional address details, PO Box if applicable, postal code, and the country of domicile abroad.
3. Provide your contact information by filling in the appropriate telephone numbers, including private and mobile numbers, as well as your email address.
4. Specify the inception date of your contract by marking the valid start date, ensuring you use the correct format (DD.MM).
5. Indicate the franchise variation by selecting an option for out-patient (CHF 900) or in-patient (CHF 3000) coverage, then enter the monthly premium amount for sickness and accident.
6. Complete the signatures section by providing the place and date for your signature as the applicant or their legal representative. Also include the information for the broker or adviser if applicable.
7. Enter the person number for the insurance salesman and the agency number as required.
8. Once all fields are completed, review the form for accuracy, then save your changes. You may choose to download, print, or share the completed form as needed.

Start completing your Amendment Form online today to ensure your health plan details are up to date.