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Research Corporation of the University of Hawaii FY 2021 2022 3.520 RCH Health PlansRCUH ACA Health Enrollment/Waiver Form (B5A) (for Recruited Employees offered RCH medical insurance under the ACA
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How to fill out rcuh-health-insurance-waiver-form-form-b-5wa

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Step 1: Download the RCUH Health Insurance Waiver Form Form B-5WA from the official website.
02
Step 2: Fill in your personal information including name, address, phone number, and email.
03
Step 3: Provide details of your current health insurance coverage, such as the name of the insurance provider and policy number.
04
Step 4: Sign and date the form to certify the information provided is accurate.
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Step 5: Submit the completed form as per the instructions provided on the form.

Who needs rcuh-health-insurance-waiver-form-form-b-5wa?

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Individuals who are eligible to waive the RCUH health insurance coverage provided by their employer and have alternative health insurance coverage that meets the required criteria.
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The rcuh-health-insurance-waiver-form-form-b-5wa is a document that allows eligible individuals to waive enrollment in a health insurance plan offered by RCUH (Research Corporation of the University of Hawaii) based on having alternative health insurance coverage.
Individuals who are eligible for health insurance through RCUH but have alternative health insurance coverage are required to file the rcuh-health-insurance-waiver-form-form-b-5wa to formally decline enrollment in the plan.
To fill out the rcuh-health-insurance-waiver-form-form-b-5wa, individuals need to provide their personal information, details of their alternative health insurance coverage, and sign the form to confirm that they understand the implications of waiving coverage.
The purpose of the rcuh-health-insurance-waiver-form-form-b-5wa is to allow individuals with existing health insurance to opt-out of the RCUH health insurance plan, ensuring they do not pay for duplicate coverage.
The form requires individuals to report their full name, employee ID, details of their alternative health insurance plan, and a declaration of understanding regarding the waiver.
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