Get Guardian Gg-013374d 2001-2025

The Guardian GG-013374D form is critical for enrolling in dental coverage, making changes, or refusing insurance. This guide provides clear, step-by-step instructions to help users complete the form online with ease.

Follow the steps to successfully complete the Guardian GG-013374D form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the planholder name (company name) clearly in the designated field. Ensure accuracy as this identifies your insurance provider.
3. In Section 1, select the appropriate option that applies to you: add employee, add spouse, or indicate if you are a new hire, previously refused coverage, or have lost other coverage. Complete any relevant fields such as marriage date or adoption date if applicable.
4. Select the type of coverage you wish to enroll in, checking the appropriate boxes next to employee, spouse, or child(ren). Choose from the specified plans like indemnity, PPO, or Pre-Paid. If opting for Pre-Paid, ensure to complete Section 6.
5. Proceed to fill out Section 5 if you or your dependents are switching from another group plan due to loss of coverage. Indicate the reason for loss and provide dates where necessary.
6. Fill in personal details including the employee's name, marital status, and birth date. Provide the Social Security number and address. Ensure all information is printed clearly in black or blue ink.
7. If necessary, indicate if you need to add or drop dependents in Section 6. Complete any subsections related to changes or refusals of coverage.
8. Review all entered information for accuracy. Ensure signatures and dates are included where required, confirming you have read and understood the terms.
9. Once completed, save your changes. You can then choose to download, print, or share the form as needed, maintaining a copy for your records.

Complete your document online and ensure your dental coverage is accurately set up today.