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Small BusinessEMPLOYEE/DEPENDENT CHANGE
INSTRUCTIONS
1. The employer must complete Section 1.
2. The employer is responsible for confirming all information prior to submitting. Please make sure effective
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What is employeedependent change?
Employee-dependent change refers to any modification or update made to an employee's dependent information, such as adding or removing dependents from an employee's benefits coverage.
Who is required to file employeedependent change?
Employees are typically required to file an employee-dependent change when there is a qualifying life event that affects their dependent information.
How to fill out employeedependent change?
Employees can usually fill out an employee-dependent change form provided by their employer or benefits administrator, and submit any required documentation to support the change.
What is the purpose of employeedependent change?
The purpose of an employee-dependent change is to ensure that an employee's benefits coverage accurately reflects their current dependent situation, allowing for appropriate coverage and benefits allocation.
What information must be reported on employeedependent change?
Employee-dependent change typically requires reporting of dependent's name, relationship to employee, date of birth, and any relevant supporting documentation, such as marriage certificates or birth certificates.
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