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Certification of Dependency - BCBST 2026
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- Click ‘Get Form’ to open the Certification of Dependency - BCBST in the editor.
- Begin by entering the Subscriber Name, ID No., and Group No. in the designated fields at the top of the form.
- In Section 1, provide the Dependent Name and select their status from options such as Natural Child, Step-Child, or Adopted Child. If applicable, attach necessary documents for adopted children or legal guardianship.
- Section 3 requires you to indicate the dependent's marital status and whether they are a full-time student. If they are employed, fill in details about their employment status and earnings.
- Complete Section 4 by stating what percentage of support you provide for the dependent if they receive income from other sources.
- Finally, sign and date the form at the bottom. If a physician's certification is needed, ensure that section is completed as well.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2011 | 4.6 Satisfied (44 Votes) |
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