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Chaffed CollegeEmployee Name (printed)Office of Human Resources 2020 DEPENDENT(S) VERIFICATION ELIGIBILITYYour dependents include your lawful spouse or registered domestic partner and your eligible

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How to fill out dependent eligibility re-verification

01

Gather all necessary documents such as birth certificates, marriage certificates, and proof of residency.

02

Review the re-verification form provided by your employer or insurance company.

03

Fill out the form completely and accurately, providing all required information for each dependent.

04

Submit the form and any supporting documents by the specified deadline.

05

Follow up with your employer or insurance company to ensure that the re-verification process is complete.

Who needs dependent eligibility re-verification?

01

Employees who have dependents covered under their employer-sponsored health insurance plan.

02

Individuals who are enrolled in a flexible spending account that requires periodic re-verification of dependent eligibility.

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What is dependent eligibility re-verification?

Dependent eligibility re-verification is the process of verifying that dependents listed on an individual's benefits plan are still eligible for coverage.

Who is required to file dependent eligibility re-verification?

All employees who have dependents listed on their benefits plan are required to file dependent eligibility re-verification.

How to fill out dependent eligibility re-verification?

Dependent eligibility re-verification can usually be completed online through the employer's benefits portal by providing necessary documentation.

What is the purpose of dependent eligibility re-verification?

The purpose of dependent eligibility re-verification is to ensure that only eligible dependents are receiving benefits and to prevent improper use of the benefits plan.

What information must be reported on dependent eligibility re-verification?

Dependent eligibility re-verification typically requires providing proof of relationship (such as birth certificates or marriage certificates) and proof of eligibility (such as tax documents or school enrollment records).

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