Get the free WA STATE PEBB DEPENDENT CARE ASSISTANCE PROGRAM (DCAP) CLAIM ...

WA STATE WEBB DEPENDENT CARE ASSISTANCE PROGRAM (CAP) CLAIM FORM FOR PLAN YEAR JANUARY 1, 2020, through DECEMBER 31, 2020, All claims for 2020 plan year must be submitted to Nadia Benefit Solutions

How to fill out wa state pebb dependent

How to fill out wa state pebb dependent

1. To fill out the Washington State Public Employees Benefits (PEBB) dependent form, follow these steps: 1. Obtain the fillable PEBB dependent form from the official website or your employer. 2. Read the instructions provided on the form to understand the requirements. 3. Fill out the form using black ink or type the information directly into the fields. 4. Enter the dependent's personal information accurately, including their full name, date of birth, and Social Security Number. 5. Provide supporting documentation if required, such as a birth certificate or marriage certificate. 6. Fill out the sections regarding eligibility and relationship to the primary enrollee. 7. Review the completed form for any errors or missing information. 8. Sign and date the form before submitting it to the appropriate entity, such as your employer or the PEBB program office. 9. Keep a copy of the filled-out form for your records. 10. Follow up with the relevant parties to ensure the form has been received and processed.

Who needs wa state pebb dependent?

1. The Washington State PEBB dependent coverage is needed by individuals who are eligible for the PEBB program and wish to extend their health insurance benefits to their dependents. This includes eligible state employees, school employees, higher education employees, retirees, and their eligible dependents such as spouses, domestic partners, and children.

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What is wa state pebb dependent?

WA state PEBB dependent is a program that provides health benefits for dependents of eligible state employees.

Who is required to file wa state pebb dependent?

State employees who have dependents that they want to add to their health benefits coverage are required to file WA state PEBB dependent.

How to fill out wa state pebb dependent?

To fill out WA state PEBB dependent, state employees need to complete the necessary forms provided by the PEBB program and submit them with the required documentation.

What is the purpose of wa state pebb dependent?

The purpose of WA state PEBB dependent is to ensure that dependents of eligible state employees have access to health benefits coverage.

What information must be reported on wa state pebb dependent?

State employees must report information such as the dependent's name, relationship to the employee, date of birth, and social security number on WA state PEBB dependent forms.