Nj du31 2026

1. Click ‘Get Form’ to open the nj du31 in the editor.
2. Begin by filling out the Group & Employee Information section. Enter the Group Name and Group Number/Control Number as required.
3. 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.
4. Provide billing information for the young adult dependent if applicable, including their address details.
5. 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.
6. 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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