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UnitedHealthcare INSURANCE COMPANY CONTINUATION ENROLLMENT FORM FOR GTA/GRA/GA AND THEIR DEPENDENTS KANSAS BOARD OF REGENTS STATE UNIVERSITIES 2014-200118-3 PRIMARY INSURED COMPLETE INFORMATION BELOW
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How to fill out 2014-3 continuation enrollment form:

01
Start by reading the instructions provided with the form. This will provide you with a clear understanding of the information required and the sections you need to complete.
02
Fill out your personal information accurately. This includes your full name, contact details, address, date of birth, and any other necessary identification details.
03
Provide the required information about your current enrollment status. This may include details about your current healthcare plan, coverage dates, and any changes you wish to make.
04
If you have any dependents, include their information as well. This will typically require their full names, dates of birth, and relationship to you.
05
Review all the information you have entered to ensure its accuracy. Double-check all the sections and verify that you have not missed any required fields.
06
Sign and date the form. In some cases, you may need to get your signature witnessed or notarized, depending on the specific requirements outlined in the instructions.
07
Submit the completed form according to the instructions provided. This may involve mailing it to a specific address or submitting it online through a designated portal.

Who needs 2014-3 continuation enrollment form?

01
Individuals who are already enrolled in a healthcare plan for the year 2014-3 and wish to continue their coverage for the designated period.
02
Individuals who need to make changes to their current enrollment, such as adding or removing dependents, updating personal information, or altering their coverage options.
03
Those who have experienced a qualifying life event, such as marriage, divorce, birth, adoption, or significant changes in income, and need to update their enrollment accordingly.
It is important to note that specific eligibility criteria and requirements may vary depending on the organization or program administering the form. Therefore, it is advisable to review the instructions and guidelines provided with the form to ensure accurate completion and submission.
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3 continuation enrollment form is a form used by individuals who wish to continue their enrollment in a particular program or course.
Individuals who are currently enrolled in a program or course and wish to continue their enrollment are required to file the 3 continuation enrollment form.
To fill out the 3 continuation enrollment form, individuals must provide their personal information, program/course details, and any additional information required by the institution.
The purpose of the 3 continuation enrollment form is to inform the institution of the individual's intention to continue their enrollment in a program or course.
The 3 continuation enrollment form typically requires personal information, program/course details, and any additional information requested by the institution.
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