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WORKERS UNITED CANADA BENEFITS TRUST FUND
SUPPLEMENTARY HEALTH
STATEMENT OF EXPENSES
INSTRUCTIONS:Attach the bills and receipts for all expenses and itemize them by providing all the information requested.
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How to fill out supplementary health form
How to fill out supplementary health form
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To fill out the supplementary health form, follow these steps:
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- Start by reading the instructions provided with the form to understand the requirements and information needed.
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- Gather all the necessary personal information such as name, address, contact details, and identification number.
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- Provide details about your current health insurance coverage, if any.
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- Fill in the sections regarding your medical history, including any pre-existing conditions or ongoing treatments.
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- If required, attach any supporting documents such as medical reports or prescriptions.
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- Review the completed form to ensure all information is accurate and complete.
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- Sign and date the form.
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- Finally, submit the form to the designated recipient or follow the specified submission process.
Who needs supplementary health form?
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The supplementary health form may be necessary for individuals who require additional health coverage beyond what their primary health insurance provides.
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It can also be required for individuals seeking to enroll in specific health programs or benefits that have eligibility criteria.
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Those who are considering making changes to their existing health insurance coverage or switching to a different plan may also need to fill out this form.
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It is advisable to consult with the relevant health insurance provider or program administrator to determine if the supplementary health form is required in your particular situation.
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