Listed below are some important forms within our office and how to add and remove dependents from insurance.
Documentation needed to add/remove dependents:
To add a spouse-
- Copy of Marriage certificate & new Iowa Laborer’s Health & Welfare Plan enrollment form.
- Statement of “loss of coverage” & new enrollment forms
To add a new baby/adopted child-
- New enrollment forms, copy of social security card, copy of birth certificate.
- New enrollment forms & signed, dated copy of the adoption papers & copies of the new birth certificates.
To add a child-
- Copy of the child’s birth certificate; if you are not listed on the birth certificate as the child’s father/mother, then we will also need a court order establishing paternity or something from the state showing payment of child support.
To add a step-child-
- New enrollment forms.
- Copy of the most recent tax statement naming the child as a dependent.
- Notarized statement signed by the participant and their spouse stating that the child is a) living with the participant in a regular parent/child relationship; b) that you contribute more that 50% toward the maintenance and support of the said child; c) the child is neither covered nor required to be covered by any other health plan or person.
To term/delete a dependent-
- New enrollment forms.
- Signed & dated copy of a divorce decree or
- Letter of credible coverage or
- Copy of death certificate.
If you have any questions on how to fill out the forms, please call 319-366-0859.
Please mail all forms to the addresses listed on the forms.