SPOUSAL COORDINATION OF BENEFITS

Documentation and Forms

• Spousal Coordination of Benefits Policy
• Spousal Policy Frequently Asked Questions
• Spousal Coordination of Benefits - Electronic Form
   

If you cover your spouse in one of the State of Delaware's Group Health Insurance medical plans; you MUST complete a new Spousal Coordination of Benefits form each year during Open Enrollment and anytime their employment or insurance status changes.

IMPORTANT INFORMATION:
IF YOUR SPOUSE IS COVERED BY A HIGH DEDUCTIBLE HEALTH PLAN THAT INCLUDE A HEALTH SAVINGS ACCOUNT

• Spousal HD/HSA Policy
   

ADULT DEPENDENTS TO AGE 26 - COORDINATION OF BENEFITS

Documentation and Forms

• Adult Dependents Coordination of Benefits Policy
   
• Adult Dependent Coordination of Benefits Form
   
You may enter information directly into this form online. Once complete, you may save the form to your computer. You must print the completed form, sign it, and take it to your Human Resources/Benefits Representative. The form cannot be submitted electronically.


• Adult Dependent FAQ's
   

Last Updated: Monday April 30 2012