For assistance, problems or questions, please email us.
Page History
...
- First Box: leave as "A" Add
- Relation Code: Use drop down to select from the following:
- EE - Employee (re-type the employee's info on this row to cover them self on this policy)
- W = Wife
- H = Husband
- D = Daughter
- S = Son
- Name - Last, First, Middle Initial
- US Social Security Number XXX-XX-XXXX
- Birth date MM/DD/YYYY
- Skip 5 check boxes - not required
- Primary Country of Citizenship - USA
- Residence (Indicate if same or Different than the employee (ex. children covered under plan but living in different country for school etc.. )
- If different we may ask for the mailing address separately
...