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Commonwealth of Kentucky Personnel Cabinet Department of Employee Insurance Enrollment Information Branch (502)564-1205 (502)564-1085 Fax 2010 DEPENDENT ADD FORM Give this form to your Insurance Coordinator
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What is dependent add form?
The dependent add form is a document that is used to add dependents to a person's insurance coverage.
Who is required to file dependent add form?
Any individual who wishes to add dependents, such as spouse or children, to their insurance coverage is required to file the dependent add form.
How to fill out dependent add form?
To fill out the dependent add form, you need to provide information about the dependents, such as their names, dates of birth, and social security numbers.
What is the purpose of dependent add form?
The purpose of the dependent add form is to inform the insurance provider about the addition of new dependents to an individual's coverage.
What information must be reported on dependent add form?
The dependent add form requires you to report the names, dates of birth, and social security numbers of the dependents being added to the insurance coverage.
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