Get the free 2013-848-2 Vision Enrollment Form-v1 form

UnitedHealthcare Insurance Company Enrollment Form Vision 20138482 Mary mount Manhattan College Send completed application with check made payable to UnitedHealthcare StudentResources to: UnitedHealthcare

How to fill out 2013-848-2 vision enrollment form-v1

Who needs 2013-848-2 vision enrollment form-v1?

1. Employees who require vision insurance coverage from their employer.
2. Individuals who want to enroll in a vision insurance plan.
3. Dependents of employees who need vision insurance coverage.

How to fill out 2013-848-2 vision enrollment form-v1:

Start by providing personal information:

1. Fill in your full name, address, and contact information.
2. Include your date of birth and social security number.
3. Indicate whether you are an employee or a dependent.
4. If you are a dependent, provide the name of the employee you are dependent on.

Choose the coverage options:

1. Select the type of vision plan you are applying for.
2. Determine the coverage level you want (e.g., individual or family).
3. Specify any additional coverage options, such as contact lenses or laser vision correction.
4. Indicate whether you want to enroll in a vision discount program, if available.

Declare any other insurance coverage:

1. Specify if you have any other vision insurance coverage from a different source (e.g., another employer, spouse's plan).
2. Provide details of the coverage, including the insurance company's name, policy number, and effective dates.

Provide payment information:

1. Indicate the method of payment you prefer (e.g., payroll deduction, check, credit card).
2. If payroll deduction is chosen, authorize the employer to deduct the necessary premiums from your salary.
3. If paying by check or credit card, provide the relevant details.

Sign and date the form:

1. Read the declaration at the bottom of the form carefully.
2. Sign and date the form to confirm the accuracy of the information provided.
3. If applicable, have the employee who you are dependent on also sign the form.

Submit the form:

1. Follow the instructions provided on how to submit the completed form.
2. Submit the form within the designated timeframe, ensuring all required documentation is included.
3. Keep a copy of the form for your records.

By following these steps, you can successfully fill out the 2013-848-2 vision enrollment form-v1 and ensure your enrollment in the desired vision insurance plan.

For pdfFiller’s FAQs

What is 848-2 vision enrollment form-v1?

848-2 vision enrollment form-v1 is a document used to enroll in a vision insurance plan.

Who is required to file 848-2 vision enrollment form-v1?

Employees who wish to enroll in a vision insurance plan are required to file the 848-2 vision enrollment form-v1.

How to fill out 848-2 vision enrollment form-v1?

To fill out the 848-2 vision enrollment form-v1, provide personal information, select vision coverage options, and sign the form.

What is the purpose of 848-2 vision enrollment form-v1?

The purpose of 848-2 vision enrollment form-v1 is to enroll individuals in a vision insurance plan.

What information must be reported on 848-2 vision enrollment form-v1?

Information such as personal details, vision coverage preferences, and signature must be reported on the 848-2 vision enrollment form-v1.

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