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Get the free Request to Add Dependents - University

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This form allows students to add dependent children and/or spouse to their Major Plan coverage. Ensure eligibility and submit supporting documents within 10 days.
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A request to add dependents is a formal application submitted to include additional individuals, typically family members, in a benefits plan or insurance coverage.
Typically, the primary policyholder or insured individual is required to file the request to add dependents.
To fill out the request, complete the form provided by the relevant organization, providing necessary personal details of both the policyholder and the dependents, along with any required documentation.
The purpose of the request is to ensure that eligible family members receive coverage under the policyholder's insurance or benefits plans.
The information required typically includes the names, dates of birth, social security numbers, and relationship to the policyholder for each dependent.
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