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Get Tx Ers Gi-1.207 2021-2025
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How to fill out the TX ERS GI-1.207 online
The TX ERS GI-1.207 is a supplemental information form for employees joining the Texas Employees Group Benefits Program. This guide will help you complete the form online, ensuring that all necessary information is accurately recorded for your health plan management.
Follow the steps to successfully complete the form online.
- Click the ‘Get Form’ button to obtain the form and open it in your online editor.
- In Section A, provide your employee data. Indicate if you are a new employee, then fill in your birthdate, full name, last four digits of your social security number, phone number, and mailing address including your city, state, ZIP code, and eligibility county.
- Proceed to Section B for other insurance data. Check the type of coverage you have, such as employer group health or dental. Fill in the policyholder's name, ID number, birthdate, and gender, along with the name and address of your other insurance company and coverage details.
- In Section C, provide details about any Medicare coverage. Enter the effective dates for Medicare Part A and Part B if applicable, along with the Medicare number.
- For Section D, which is for those participants in HealthSelect of Texas, you will need to select a primary care provider. Write the name of your health plan and the full name and provider code of your chosen PCP for yourself and each covered dependent.
- In Section E, complete details for any other covered dependents who do not reside in your household, providing their names and mailing addresses.
- Review all entered information for accuracy. After ensuring all fields are completed, you can save your changes, download a copy for your records, print the form, or share it as needed.
- Finally, sign and date the form before mailing it to your health plan.
Complete your TX ERS GI-1.207 form online today to manage your benefits effectively.
An ERS, or Employees Retirement System, is a retirement plan that supports public sector workers in Texas during their retirement years. It collects funds from employees and employers to provide reliable monthly benefits. For those looking into the specifics of TX ERS GI-1.207, it is an excellent starting point to understand your benefits and planning needs.
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