Get the free Supplemental Plan Form 1213 (2).doc - nursing lsuhsc

LSU HEALTH SCIENCES CENTER SUPPLEMENTAL STUDENT ACCIDENT AND SICKNESS PLAN ACADEMIC YEAR 2012/2013 As part of the acceptance criteria to LOUIS, I agreed to purchase and maintain adequate health insurance

How to fill out supplemental plan form 1213

How to fill out supplemental plan form 1213:

1. Start by obtaining the form: The supplemental plan form 1213 can typically be obtained from your insurance provider. Contact them or check their website to find out how to obtain the form.
2. Read the instructions carefully: Before filling out the form, take the time to read and understand the instructions provided. This will ensure that you fill out the form correctly and provide all the necessary information.
3. Provide personal information: The form will require you to provide your personal information such as your name, address, contact details, and social security number. Make sure to accurately fill in each field.
4. Specify the type of supplemental plan: The form may ask you to indicate the type of supplemental plan you are applying for. This could include options such as dental, vision, prescription drug coverage, or others. Select the appropriate option based on your needs.
5. Provide supporting documentation: Depending on the plan you are applying for, you may need to provide supporting documents such as proof of income, medical records, or other relevant paperwork. Ensure you attach all necessary documentation as required.
6. Choose your coverage options: The form may provide you with choices and options to select for your coverage. Carefully review these options and select the ones that best suit your needs. Take note of any additional costs or limitations associated with each choice.
7. Review and double-check the form: Before submitting the form, thoroughly review each section to ensure that you have provided accurate and complete information. Look for any errors or omissions that need to be corrected.
8. Sign and submit the form: Once you are confident that all the information provided is accurate, sign the form and follow the instructions for submission. This may involve mailing it to the insurance provider or submitting it electronically, depending on their preferred method.

Who needs supplemental plan form 1213?

Individuals who require additional insurance coverage beyond their primary insurance plan may need to fill out the supplemental plan form 1213. This form is typically used to apply for various types of supplemental coverage, such as dental, vision, prescription drugs, or other specific services not covered by the primary insurance plan. In some cases, individuals may be required to fill out this form as part of their employer-sponsored benefits enrollment process. It is important to check with your insurance provider or employer to determine if you need to fill out the supplemental plan form 1213.

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