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Working Spouse Premium Election Form
The Working Spouse Premium applies if you elect to cover a spouse/domestic partner on your
Ben elect medical insurance plan who has access to group health insurance
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How to fill out working spouse premium election

How to fill out working spouse premium election
01
To fill out the working spouse premium election, follow these steps:
1. Obtain the working spouse premium election form from your employer or insurance provider.
02
Read the instructions and requirements carefully to ensure eligibility for the premium election.
03
Provide your personal information such as name, address, and contact details.
04
Fill out the details of your working spouse, including their name, employer's name, and employment status.
05
Indicate the type of coverage and premium rate you wish to elect for your working spouse.
06
Sign and date the working spouse premium election form.
07
Submit the completed form to your employer or insurance provider as per their instructions.
08
Keep a copy of the filled-out form for your records.
Who needs working spouse premium election?
01
Anyone who has a working spouse and has access to employee benefits, including health insurance, needs to fill out a working spouse premium election.
02
This is necessary for employees who have the option to cover their working spouse under their employer-provided health insurance plan.
03
The working spouse premium election allows employees to choose whether or not to include their working spouse in their health insurance coverage and pay the corresponding premium for such coverage.
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What is working spouse premium election?
The working spouse premium election is a process where an employee elects to either opt-in or opt-out of paying an additional premium to cover their spouse under the employer's health insurance plan.
Who is required to file working spouse premium election?
Employees who have a working spouse that is eligible for coverage under the employer's health insurance plan are required to file the working spouse premium election.
How to fill out working spouse premium election?
Employees can fill out the working spouse premium election by completing the designated form provided by the employer and indicating whether they want to opt-in or opt-out of covering their spouse.
What is the purpose of working spouse premium election?
The purpose of the working spouse premium election is to give employees the option to decide whether they want to pay an additional premium to cover their working spouse under the employer's health insurance plan.
What information must be reported on working spouse premium election?
The working spouse premium election form typically requires employees to provide information about their spouse's eligibility for coverage, as well as their decision to opt-in or opt-out of the coverage.
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