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Graduate Assistant Health Plan
20162017 Continuation of Coverage
Enrollment and Change Form
After losing eligibility for the Graduate Assistant Health Plan (for example, your assistant ship drops
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How to fill out after losing eligibility for
How to fill out after losing eligibility for
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Here are the steps to fill out after losing eligibility for:
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Identify the specific application or form that needs to be filled out.
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Read and understand the instructions provided on the application form.
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Fill out the personal details section accurately, providing all necessary information such as name, address, contact information, etc.
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Provide the relevant details about the loss of eligibility, including the reasons and any supporting documentation if required.
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Sign and date the completed form as per the provided instructions.
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Submit the filled-out application form along with any required supporting documents through the designated channel (online submission, mail, etc.).
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Keep a copy of the filled-out form and any submitted documents for future reference.
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Follow up on the application status if necessary and take any further actions as instructed by the relevant authority.
Who needs after losing eligibility for?
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