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UPDATE DEPENDENT/BENEFICIARY INFORMATION EMPLOYEES Polyfill in all pertinent information. Send this form to the LENS Benefits Office, L640.HEALTH AND WELFARE PLANS (REV. 6/22/17)Lawrence Livermore
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How to fill out beneficiary designation - health
How to fill out beneficiary designation - health
01
Obtain the beneficiary designation form from the health insurance provider or employer.
02
Fill out your personal information, such as your full name, date of birth, and social security number.
03
Provide the contact information of your primary beneficiary, including their full name, address, and relationship to you.
04
If you wish to designate a secondary (contingent) beneficiary, include their information as well.
05
Specify the percentage or portion of the benefit each beneficiary should receive.
06
Review the completed form for accuracy and sign it.
07
Submit the form to the health insurance provider or employer as instructed.
Who needs beneficiary designation - health?
01
Anyone who has a health insurance policy or a designated health benefit through their employer should consider filling out a beneficiary designation for health.
02
It is especially important for individuals who want to ensure that their health benefits are passed on to specific individuals in the event of their death.
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What is beneficiary designation - health?
Beneficiary designation - health refers to specifying who will receive the health benefits in case of the policyholder's death.
Who is required to file beneficiary designation - health?
The policyholder or the main policyholder of the health insurance plan is required to file beneficiary designation - health.
How to fill out beneficiary designation - health?
To fill out beneficiary designation - health, the policyholder must provide the name, contact information, and relationship to the beneficiary.
What is the purpose of beneficiary designation - health?
The purpose of beneficiary designation - health is to ensure a seamless transfer of health benefits to the designated beneficiary in case of the policyholder's death.
What information must be reported on beneficiary designation - health?
The beneficiary's name, contact information, relationship to the policyholder, and any specific instructions regarding the distribution of benefits must be reported on beneficiary designation - health.
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