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Calpers hbd 2026
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- Click ‘Get Form’ to open the calpers HBD in the editor.
- Begin by entering your Employee Information, including your Social Security Number and full name (first, middle, last). Ensure accuracy as this information is crucial for processing.
- In Part A, select the appropriate box if you are enrolling yourself and all eligible dependents. If you have dependents with other coverage, proceed to Part B.
- For Part B-1, check the box if you are enrolling only yourself while your dependents have other health insurance. In Part B-2, indicate if you are enrolling yourself and some dependents who have other coverage.
- In Part C, mark the relevant box if you are declining enrollment for yourself or your dependents due to having other health insurance. Be sure to read any special instructions regarding changes in family situations.
- Finally, sign and date the form at the bottom. Ensure that all sections are completed before submitting it through our platform for processing.
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calpers hbd 12 form
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