Get the free Non-Smoker Certification

This document certifies that the subscriber or applicant, as well as their spouse, have not used tobacco in the past 12 months, entitling them to a non-smoker discount on their health plan.

How to fill out non-smoker certification

How to fill out Non-Smoker Certification

1. Obtain the Non-Smoker Certification form from your employer or the relevant authority.
2. Fill out your personal information such as name, address, and date of birth.
3. Indicate your smoking status by checking the appropriate box (non-smoker).
4. Provide any additional information required, such as the duration of non-smoking.
5. Sign and date the form to validate your statement.
6. Submit the completed form to the designated office or supervisor.

Who needs Non-Smoker Certification?

1. Individuals applying for jobs that require a non-smoking status.
2. Employees seeking health insurance benefits that offer lower premiums for non-smokers.
3. Participants in wellness programs aimed at promoting a smoke-free environment.
4. Individuals looking to rent or purchase properties with non-smoking policies.

People Also Ask about

When can I class myself as a non-smoker?

A non-smoker is someone who last smoked cigarettes or cigars, used a pipe or any other form of tobacco or nicotine products, including e-cigarettes or nicotine replacement products more than 5 years ago.

When can you class yourself as a non-smoker?

If you gave up one to five years ago, we can consider different rates, and if you haven't used tobacco or nicotine related products for five years, we'll class you as a non-smoker for life insurance. Different insurers may have different guidelines, so make sure you check with them.

How long until I can call myself a non-smoker?

As soon as you have had your last cigarette, call yourself a non-smoker.

When can I consider myself a non-smoker?

Think of yourself as a non-smoker from the moment that you quit.

What is considered a non-smoker?

Former smoker: An adult who has smoked at least 100 cigarettes in his or her lifetime but who had quit smoking at the time of interview. Never smoker: An adult who has never smoked, or who has smoked less than 100 cigarettes in his or her lifetime.

When can I say I'm a non-smoker?

You should not have used any tobacco or nicotine products for 12 months to be considered a non-smoker. This includes tobacco, vaping and even nicotine patches.

For pdfFiller’s FAQs

What is Non-Smoker Certification?

Non-Smoker Certification is a document that verifies an individual's non-smoking status, often required by health insurance companies or employers for specific benefits or lower premiums.

Who is required to file Non-Smoker Certification?

Individuals who wish to confirm their non-smoking status for health benefits, insurance applications, or employment purposes are required to file Non-Smoker Certification.

How to fill out Non-Smoker Certification?

To fill out Non-Smoker Certification, individuals typically need to provide personal information, sign a declaration confirming their non-smoking status, and may need to have the form witnessed or certified by a healthcare provider.

What is the purpose of Non-Smoker Certification?

The purpose of Non-Smoker Certification is to validate an individual's non-smoking status to potentially reduce insurance premiums, access health benefits, or meet workplace health requirements.

What information must be reported on Non-Smoker Certification?

The information that must be reported on Non-Smoker Certification generally includes the individual's name, date of birth, declaration of non-smoking status, and possibly the date of the last exposure to tobacco.