Get Case 0910 Dependent Brochure.rtf

Filling out the Case 0910 Dependent Brochure is an essential step for users seeking to enroll their dependents in the Optional Medical Plan. This guide provides a clear, step-by-step approach to ensure that you complete the form accurately and efficiently online.

Follow the steps to successfully fill out the Case 0910 Dependent Brochure online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Carefully read the eligibility criteria outlined in the brochure. Ensure that you qualify to enroll your dependents under the specified conditions.
3. Fill in your name and student ID in the designated fields. This information is crucial for identifying your enrollment.
4. Complete the address section with your current address, ensuring it is accurate to avoid any issues with processing.
5. Indicate whether you have purchased the Case Western Reserve University Student Medical Plan by checking the appropriate box or selecting the option.
6. List the dependents you wish to enroll. For each dependent, provide the required information such as name, birth date, and gender.
7. Review the annual costs for each dependent category and ensure you understand the payment structure.
8. Submit the completed form following the instructions provided in the guide, which might include sending it to the University Health Service via mail or fax.
9. Keep a copy of your completed form and any correspondence for your records.
10. Save changes to the form, if necessary, then download, print, or share the form as required.

Complete your enrollment documents online today to ensure your dependents are covered.