Get the free Butler University Dependent Enrollment Form ... - Gallagher Koster

Butler University Dependent Enrollment Form Student Injury & Sickness Insurance Plan 2011-2012 Policy Year Dependent Enrollment for the Annual term can also be completed online through www.gallagherkoster.com/butler.

How to fill out butler university dependent enrollment

How to fill out Butler University dependent enrollment:

1. Obtain the dependent enrollment form from Butler University's website or the HR department.
2. Provide personal information including the dependent's full name, date of birth, and social security number.
3. Indicate the relationship between the dependent and the enrollee (e.g., child, spouse).
4. If the dependent is a child, provide information regarding their eligibility for coverage (e.g., student status, disability).
5. Specify the desired coverage start date and any other relevant details.
6. Sign and date the form, ensuring that all required fields are completed accurately.
7. Submit the filled-out form to the designated department or individual responsible for processing dependent enrollments at Butler University.

Who needs Butler University dependent enrollment:

1. Students at Butler University who wish to enroll their eligible dependents in the university's health insurance plan.
2. Faculty and staff members at Butler University who want to provide coverage for their eligible dependents.

Note: Butler University's dependent enrollment requirements may vary, so it is advisable to refer to the specific instructions and guidelines provided by the university.

For pdfFiller’s FAQs

What is butler university dependent enrollment?

Butler University dependent enrollment is the process of registering dependents of students, faculty, or staff for benefits such as health insurance and tuition assistance.

Who is required to file butler university dependent enrollment?

Students, faculty, and staff of Butler University who wish to register their dependents for benefits must file Butler University dependent enrollment.

How to fill out butler university dependent enrollment?

Butler University dependent enrollment can typically be filled out online through the university's portal by providing the necessary information about the dependents.

What is the purpose of butler university dependent enrollment?

The purpose of Butler University dependent enrollment is to ensure that dependents of students, faculty, and staff are properly registered for benefits and services provided by the university.

What information must be reported on butler university dependent enrollment?

Information such as the dependent's name, date of birth, relationship to the student, faculty, or staff member, and any other relevant details must be reported on Butler University dependent enrollment.

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