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ALTERNATIVE COVERAGE 2026
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- Click ‘Get Form’ to open the ALTERNATIVE COVERAGE document in the editor.
- Begin by entering your Employee Name and Employer Group in the designated fields. Ensure that all information is accurate for proper processing.
- In the 'Reasons for Waiver' section, select one of the options that best describes why you are waiving coverage. If you choose 'Other', be sure to provide specific details in the space provided.
- If you have coverage elsewhere, fill in the Carrier Name and Subscriber Name fields with the relevant information to substantiate your waiver.
- Finally, sign and date the form at the bottom. This certifies that all information provided is complete and true, ensuring compliance with Tufts Health Plan requirements.
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