Get the free 2019-2020 SHBP Short-term Extension Enrollment Form - shb umn

20202021 Student Health Benefit Plan Short term Coverage Extension Enrollment Form A. Primary Member Information Name (last, first, middle initial) (please print)Date of birth (mm/dd/YYY)Street address,

How to fill out 2019-2020 shbp short-term extension

How to fill out 2019-2020 shbp short-term extension

1. To fill out the 2019-2020 SHBP short-term extension, follow these steps:
2. Obtain the short-term extension form from the SHBP website or your employer.
3. Read the instructions carefully to understand the requirements.
4. Fill out the personal information section accurately, including your name, address, and contact details.
5. Provide your SHBP identification number, if applicable.
6. Indicate the effective dates of the extension period.
7. If required, attach any supporting documents indicated in the instructions.
8. Double-check all the information entered for accuracy.
9. Sign and date the form at the designated space.
10. Submit the completed form to the SHBP office or follow the submission instructions provided.

Who needs 2019-2020 shbp short-term extension?

1. The 2019-2020 SHBP short-term extension is typically needed by individuals who require an temporary extension of their SHBP coverage beyond the current policy period.
2. This may include individuals who need additional time to find alternative health insurance coverage or those who have specific circumstances that warrant a short-term extension.
3. It is important to consult the SHBP guidelines or contact your employer to determine if you are eligible for the short-term extension.

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What is shbp short-term extension enrollment?

SHBP short-term extension enrollment allows eligible individuals to extend their coverage for a limited time period.

Who is required to file shbp short-term extension enrollment?

Individuals who are eligible for SHBP coverage and wish to extend their coverage for a short period of time.

How to fill out shbp short-term extension enrollment?

To fill out SHBP short-term extension enrollment, individuals must complete the necessary forms provided by the SHBP administrator and submit them before the deadline.

What is the purpose of shbp short-term extension enrollment?

The purpose of SHBP short-term extension enrollment is to allow eligible individuals to maintain their coverage for a temporary period.

What information must be reported on shbp short-term extension enrollment?

Information such as personal details, coverage start and end dates, reason for extension, and any other required documentation.