Get the free Certification of Over-age Dependent Eligibility Form
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This form is used to certify the eligibility of over-age dependents for coverage under the City of Tampa Group Insurance health plan, in accordance with Florida Statute 627.6562. It requires completion of dependent information and attestation of their eligibility status.
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What is certification of over-age dependent?
Certification of over-age dependent is a formal document that verifies the status of a dependent who is over the age limit set by an insurance or benefits plan.
Who is required to file certification of over-age dependent?
Typically, policyholders or subscribers who wish to maintain coverage for their over-age dependents are required to file the certification.
How to fill out certification of over-age dependent?
To fill out the certification, provide all required personal information of the dependent, including name, relationship to the policyholder, age, and any necessary documentation required by the insurance provider.
What is the purpose of certification of over-age dependent?
The purpose of the certification is to confirm that the dependent still qualifies for coverage under the insurance policy, despite being over the standard age limit.
What information must be reported on certification of over-age dependent?
The information that must be reported typically includes the dependent's name, age, relationship to the policyholder, and any required proofs of education or incapacity if applicable.
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