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Click ‘Get Form’ to open the nj du31 in the editor.
Begin by filling out the Group & Employee Information section. Enter the Group Name and Group Number/Control Number as required.
In the Type of Activity section, check all applicable boxes for changes, such as adding or removing a young adult dependent. Specify the Effective Date of Coverage.
Provide billing information for the young adult dependent if applicable, including their address details.
Complete the Young Adult Dependent Information section by entering their name, birthdate, and other health coverage details. Ensure to indicate if they are a current patient.
Finally, both the employee and young adult dependent must sign and date the form to confirm that all information is accurate.
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Coverage of Young Adults in New Jersey Up to Age 31
The DU31 law applies to all New Jersey group health benefits plans regardless of the size of the employer but does not apply to most self-funded plans. ARead more
1. Is 30 years of age or younger; 2. Is unmarried; 3. Has no dependent of his or her own; 4. Is a New Jersey resident or enrolled as a full-time student atRead more
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